title: Incidence, surgical procedures, and outcomes of hip fracture among elderly type 2 diabetic and non-diabetic patients in Spain (2004-2013).
abstract: Hip fracture is a serious public health problem. We used Spanish hospital discharge data to examine trends in 2004-2013 in the incidence of hip fracture among elderly patients. We found that hip fracture incidence is higher in subjects with than without diabetes and is much higher among women than men.
  
  
  BACKGROUND
  This study aimed to describe trends in the incidence of hip fracture hospitalizations, use of surgical procedures, and hospital outcomes among elderly patients with and without type 2 diabetes mellitus (T2DM) in Spain, 2004-2013.
  
  
  METHODS
  We selected all patients with a discharge primary diagnosis of hip fracture using the Spanish national hospital discharge database. Discharges were grouped by diabetes status: Incidences were calculated overall and stratified by diabetes status and year. We analyzed surgical procedures, length of hospital stay (LOHS), and in-hospital mortality (IHM). Multivariate analysis was adjusted by age, year, comorbidity, and in-hospital complications (IHC).
  
  
  RESULTS
  From 2004 to 2013, 432,760 discharges with hip fracture were identified (21.3 % suffered T2DM). Incidence among diabetic men and women increased until year 2010 and then remained stable. Diabetic women have three times higher incidence than diabetic men. Incidences and IHC were higher among patients with diabetes beside sex. The proportion of patients that underwent internal fixation increased for all groups of patients and the arthroplasty repair decreased. After multivariate analysis, IHM has improved over the study period for all patients. Suffering diabetes was associated to higher IHM in women (odds ratio (OR) 1.12; 95 % confidence interval (CI) 1.07-1.17).
  
  
  CONCLUSIONS
  Hip fracture incidence is higher in subjects with than without diabetes and is much higher among women than men. In diabetic patients, incidence rates increased initially but have leveled from 2010 onwards. For all groups, the use of internal fixation has increased overtime and IHM and LOHS have decreased from 2004 to 2013.
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain. ana.lopez@urjc.es.
authors: A
authors: A
authors: Lopez-de-Andrés
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain. rodrigo.jimenez@urjc.es.
authors: R
authors: R
authors: Jiménez-García
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain. isabel.jimenez@urjc.es.
authors: I
authors: I
authors: Jiménez-Trujillo
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain. valentin.hernandez@urjc.es.
authors: V
authors: V
authors: Hernández-Barrera
authors: Medicine Department, Hospital Gregorio Marañon, Madrid, Comunidad de Madrid, Spain. josemaria.demiguel@salud.madrid.org.
authors: J M
authors: JM
authors: de Miguel-Yanes
authors: Medicine Department, Hospital Clínico San Carlos, Madrid, Comunidad de Madrid, Spain. manuel.mendez@salud.madrid.org.
authors: M
authors: M
authors: Méndez-Bailón
authors: Health Security Agency, Ministry of Health, Madrid, Comunidad de Madrid, Spain. nperezf@msssi.es.
authors: N
authors: N
authors: Perez-Farinos
authors: Pneumology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Comunidad de Madrid, Spain. javier.miguel@salud.madrid.org.
authors: J
authors: J
authors: de Miguel-Diez
authors: Dirección Técnica de Docencia e Investigación, Gerencia Atención Primaria, Madrid, Comunidad de Madrid, Spain. miguel.salinero@salud.madrid.org.
authors: M Á
authors: MÁ
authors: Salinero-Fort
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain. pilar.carrasco@urjc.es.
authors: P
authors: P
authors: Carrasco-Garrido
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data / Q000639:trends; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data / Q000639:trends; D006620:Hip Fractures / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
keywords: Aged; Hip fracture; Hospitalizations; In-hospital mortality; Surgical procedures; Type 2 diabetes