title: Incidence of hip fractures in Germany, 1995-2010.
abstract: We analyzed hip fracture incidence trends in Germany in 1995-2010, using national hospital discharge register. Overall, after age-sex-region adjustment, there was no significant trend. However, stratified analyses showed a significant decrease in younger people. In the elderly, there was a moderate increase in men and decrease in women. Incidences were still higher in Western Germany (each significant).
  
  
  BACKGROUND
  Whereas most studies from US and European countries found trends of a decreasing hip fracture incidence in the last years, in Germany, an increase has been still observed up to 2003.
  
  
  METHODS
  Analysis of annual hip fracture incidences in Germany was carried out using the national hospital discharge register and a correction factor of 0.89. Estimate of age-sex-adjusted changes was determined using the Poisson regression (incidence rate ratios, IRR; with 95 % confidence intervals, CI), overall and in age-sex-region strata.
  
  
  RESULTS
  The number of patients with at least one hospital admission for hip fracture increased (1995: n = 99,146; 2010: n = 128,240). Overall, after adjustment for age, sex, and region, there was no significant trend during the observation period. However, in stratified analyses, a significant decrease was seen in people aged less than 40 years in both sexes and regions. Also, in women aged 60 years or older, the incidence decreased (Western Germany p = 0.001) or remained (Eastern Germany p = 0.053) (IRR 1995-2010, 95 % CI: 0.95, 0.92-0.98; and 1.05, 0.999-1.11). In contrast, the incidence in men 40-59 and 60 years older increased in both regions (West: 1.03, 0.97-1.09; and 1.11, 1.07-1.14; East: 1.12, 1.01-1.25; and 1.29, 1.22-1.36). While incidences were still significantly higher in Western Germany overall and in most strata, they tended to converge.
  
  
  CONCLUSIONS
  In line with most European countries, the overall hip fracture incidence in Germany no longer increases. However, differences between age, sex, and region exist.
authors.affiliation: Department of Public Health, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstr. 59, 40225 Düsseldorf, Germany. andrea.icks@uni-duesseldorf.de
authors.forename: Andrea
authors.initials: A
authors.lastname: Icks
authors.forename: Werner
authors.initials: W
authors.lastname: Arend
authors.forename: Clemens
authors.initials: C
authors.lastname: Becker
authors.forename: Kilian
authors.initials: K
authors.lastname: Rapp
authors.forename: Pascal
authors.initials: P
authors.lastname: Jungbluth
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Haastert
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D055815:Young Adult