"Burden of osteoporotic fractures in primary health care in Catalonia (Spain): a population-based study".
BACKGROUND
Knowledge on the epidemiology of non-hip fractures in Spain is limited and somewhat outdated. Using computerized primary care records from the SIDIAP database, we derived age and sex-specific fracture incidence rates for the region of Catalonia during the year 2009.


METHODS
The SIDIAP database contains quality-checked clinical information from computerized medical records of a representative sample of >5,800,000 patients (80% of the population of Catalonia). We conducted a retrospective cohort study including all patients aged ≥50 years, and followed them from January 1 to December 31, 2009. Major osteoporotic fractures registered in SIDIAP were ascertained using ICD-10 codes and validated by comparing data to hospital admission and patient-reported fractures records. Incidence rates and 95% confidence intervals were calculated.


RESULTS
In total, 2,011,430 subjects were studied (54.6% women). Overall fracture rates were 10.91/1,000 person-years (py) [95%CI 10.89-10.92]: 15.18/1,000 py [15.15-15.21] in women and 5.78/1,000 py [5.76-5.79] in men. The most common fracture among women was wrist/forearm (3.86/1,000 py [3.74-3.98]), while among men it was clinical spine (1.25/1,000 py [1.18-1.33]). All fracture rates increased with age, but varying patterns were observed: while most of the fractures (hip, proximal humerus, clinical spine and pelvis) increased continuously with age, wrist and multiple rib fractures peaked at age 75-80 and then reached a plateau.


CONCLUSIONS
Our study provides local estimates of age, sex and site-specific fracture burden in primary health care, which will be helpful for health-care planning and delivery. A proportion of fractures are not reported in primary care records, leading to underestimation of fracture incidence rates in these data.
Institut Català de la Salut, Barcelona, Spain.
Aina
A
Pagès-Castellà
Cristina
C
Carbonell-Abella
Francesc Fina
FF
Avilés
Maite
M
Alzamora
Jose Miguel
JM
Baena-Díez
Daniel Martínez
DM
Laguna
Xavier
X
Nogués
Adolfo
A
Díez-Pérez
Daniel
D
Prieto-Alhambra
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors