title: A systematic review of hip fracture incidence and probability of fracture worldwide.
abstract: The country-specific risk of hip fracture and the 10-year probability of a major osteoporotic fracture were determined on a worldwide basis from a systematic review of literature. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries.
  
  
  BACKGROUND
  The present study aimed to update the available information base available on the heterogeneity in the risk of hip fracture on a worldwide basis. An additional aim was to document variations in major fracture probability as determined from the available FRAX models.
  
  
  METHODS
  Studies on hip fracture risk were identified from 1950 to November 2011 by a Medline OVID search. Evaluable studies in each country were reviewed for quality and representativeness and a study (studies) chosen to represent that country. Age-specific incidence rates were age-standardised to the world population in 2010 in men, women and both sexes combined. The 10-year probability of a major osteoporotic fracture for a specific clinical scenario was computed in those countries for which a FRAX model was available.
  
  
  RESULTS
  Following quality evaluation, age-standardised rates of hip fracture were available for 63 countries and 45 FRAX models available in 40 countries to determine fracture probability. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries.
  
  
  CONCLUSIONS
  Worldwide, there are marked variations in hip fracture rates and in the 10-year probability of major osteoporotic fractures. The variation is sufficiently large that these cannot be explained by the often multiple sources of error in the ascertainment of cases or the catchment population. Understanding the reasons for this heterogeneity may lead to global strategies for the prevention of fractures.
authors.affiliation: WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, UK. w.j.pontefract@sheffield.ac.uk
authors.forename: J A
authors.initials: JA
authors.lastname: Kanis
authors.forename: A
authors.initials: A
authors.lastname: Odén
authors.forename: E V
authors.initials: EV
authors.lastname: McCloskey
authors.forename: H
authors.initials: H
authors.lastname: Johansson
authors.forename: D A
authors.initials: DA
authors.lastname: Wahl
authors.forename: C
authors.initials: C
authors.lastname: Cooper
mesh_terms: D000368:Aged; D005260:Female; D014943:Global Health; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D015233:Models, Statistical; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors