title: Regional variability in changes in the incidence of hip fracture in the Spanish population (2000-2012).
abstract: The objective is to analyse the evolution of the incidence of hip fracture in the female population of Spain from 2000 to 2012 and to establish the possible changes which may have been seen over this period of time, including the trends in the different regions of the country.
  
  
  BACKGROUND
  Fragility-related hip fractures are considered to be the fractures of greatest significance to public health due to their high degree of morbidity and mortality. The change in their incidence, both in absolute values and when adjusted for age, is the subject of debate. The objective of this article is to describe the changes in the rates of hip fracture in Spain by autonomous community between the years 2000 and 2012.
  
  
  METHODS
  Using the data from the Spanish Minimum Basic Data Set, in which are all the recorded cases of women with a principal diagnosis of hip fracture, the incidence rates by age group and by autonomous community were obtained. Poisson distribution or negative binomial regressions were carried out to estimate the average annual change over the time period analysed.
  
  
  RESULTS
  There have been statistically significant changes in the trends of rates of incidence for all age groups of women over 65 years of age. The annual reduction was 2.2% for women of 65-74 years of age and less for those between 75 and 84. The rates of incidence for those over 85 increased annually by 0.58%.
  
  
  CONCLUSIONS
  Hip fractures continue to increase in absolute numbers, although if the rates are adjusted for age, a downward trend is seen in certain age groups. These findings have various origins, although in the absence of great changes in population structure, we believe that drug treatments for osteoporosis may play a role. There is variability in the change in incidence of hip fractures in different parts of the country. Further studies are required to be able to identify the causes.
authors.affiliation: Department of Orthopaedic, Alto Deba Hospital, Mondragón, Gipuzkoa, Spain, ietxe@yahoo.es.
authors.forename: I
authors.initials: I
authors.lastname: Etxebarria-Foronda
authors.forename: A
authors.initials: A
authors.lastname: Arrospide
authors.forename: M
authors.initials: M
authors.lastname: Soto-Gordoa
authors.forename: J R
authors.initials: JR
authors.lastname: Caeiro
authors.forename: L C
authors.initials: LC
authors.lastname: Abecia
authors.forename: J
authors.initials: J
authors.lastname: Mar
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology