Epidemiology of hip fractures in Austria: evidence for a change in the secular trend.
Hip fracture incidence rates in Austria over a period of 20 years (1989-2008) were assessed. Age-standardized incidence rates increased until 2005 but decreased thereafter. This change in the secular trend was primarily driven by a decrease in hip fracture incidence in women.


BACKGROUND
The aim of the prevailing study was to assess the incidence rates of hip fractures including changes in trend in the Austrian population over a period of 20 years (1989-2008).


METHODS
The number of hip fractures was obtained from the Austrian Hospital Discharge Register for the entire population ≥ 50 years of age. A correction factor for multiple registrations of the same diagnosis was determined. Incidence rates (cases per 100,000) of hip fracture were calculated in 5-year age intervals. To analyze the overall change in hip fracture for the period, average annual change expressed as incidence rate ratios (IRRs) was calculated.


RESULTS
The age-standardized incidence in women increased until 2005, from 493 to 642, and decreased thereafter. In men, it increased at a measured pace until 2006, from 192 to 280, and decreased thereafter with a slight rebound in 2008. The age-standardized incidence in the entire population increased until 2005, from 376 to 496, and decreased thereafter. The IRR for the last 3 years (2006-2008) was significantly below the IRR for the first 17 years (0.94, ρ < 0.01), driven by a lower IRR in women (0.91, ρ < 0.01) and to a lesser extent by a lower IRR (not statistically significant) in men (0.96, ρ < 0.15).


CONCLUSIONS
The present study indicates that since 2006, age-standardized incidence of hip fractures has been declining in the Austrian population aged 50 years and above. This reversal in the secular trend has primarily been driven by a decrease in hip fracture incidence in women.
Dimai
H P
HP
Department of Internal Medicine, Division of Endocrinology and Nuclear Medicine, Medical University of Graz, Auenbruggerpl. 15, 8036, Graz, Austria. hans.dimai@medunigraz.at
Svedbom
A
A
Fahrleitner-Pammer
A
A
Pieber
T
T
Resch
H
H
Zwettler
E
E
Chandran
M
M
Borgström
F
F
D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
Osteoporos Int. 2006 Dec;17(12):1726-33
16983459
Osteoporos Int. 2006;17(4):552-64
16408148
Osteoporos Int. 1992 Nov;2(6):285-9
1421796
Bone. 2001 Nov;29(5):413-8
11704490
Public Health Rep. 1996 Mar-Apr;111(2):146-50; discussion 151
8606913
J Bone Miner Res. 2010 May;25(5):1010-6
19929437
Acta Orthop Scand. 1999 Feb;70(1):19-22
10191741
Osteoporos Int. 2008 Aug;19(8):1139-45
18087659
BMC Geriatr. 2008 Dec 23;8:35
19105814
Osteoporos Int. 2008 Dec;19(12):1741-7
18484149
Osteoporos Int. 2005 Feb;16(2):155-62
15175845
Am J Med. 1991 Jan;90(1):107-10
1986575
Osteoporos Int. 2005 Mar;16 Suppl 2:S3-7
15365697
Lancet. 2002 May 18;359(9319):1761-7
12049882
Am J Epidemiol. 2006 Nov 15;164(10):1003-11
16928728
Osteoporos Int. 2005 Nov;16(11):1330-8
15928804
J Bone Miner Res. 2006 Dec;21(12):1836-8
17002578
J Bone Miner Res. 2005 Jun;20(6):898-905
15883628
Osteoporos Int. 2010 Mar;21(3):373-80
19436931
Bone. 2007 May;40(5):1284-9
17292683
Semin Arthritis Rheum. 2006 Apr;35(5):293-305
16616152
Osteoporos Int. 2008 May;19(5):687-97
18008100