title: Is COPD a Risk Factor for Hip Fracture?
abstract: 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 chronic obstructive pulmonary disease (COPD) in Spain (2004-2013). We selected all patients with a discharge primary diagnosis of hip fracture using the Spanish national hospital discharge database. Discharges were grouped by COPD status. From 2004 to 2013, 432,760 discharges with hip fracture were identified (6.9% suffered COPD). Incidence among COPD men increased by 2.63% per year from 2004 to 2013. There were no significant changes in tendency in the incidence among women with COPD during the study period. COPD women have almost three times higher incidence than COPD men. Incidences and hospital complications were higher among patients with COPD beside sex. The proportion of patients who underwent internal fixation increased for all groups of patients and the open reduction decreased. After multivariate analysis, in-hospital mortality (IHM) has improved over the study period for all patients. Suffering COPD was associated with higher IHM in men (odds ratio 1.45; 95% confidence interval 1.33-1.58) than women. In conclusion, hip fracture incidence is higher in subjects with than without COPD and is much higher among women than men. In COPD patients, incidence rates increased significantly in men from 2004 to 2013, but not in women. For all groups, the use of internal fixation has increased overtime and open reduction, IHM, and length of hospital stay have decreased from 2004 to 2013.
authors.affiliation: a Respiratory Department , Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM) , Madrid , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de Miguel-Diez
authors.affiliation: b Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos , Alcorcón, Madrid , Spain.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez-García
authors.affiliation: b Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos , Alcorcón, Madrid , Spain.
authors.forename: Valentin
authors.initials: V
authors.lastname: Hernández-Barrera
authors.affiliation: b Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos , Alcorcón, Madrid , Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Carrasco-Garrido
authors.affiliation: a Respiratory Department , Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM) , Madrid , Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Puente-Maestu
authors.affiliation: a Respiratory Department , Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM) , Madrid , Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Ramírez García
authors.affiliation: b Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos , Alcorcón, Madrid , Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Lopez de Andres
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000639:trends; D006620:Hip Fractures / Q000453:epidemiology* / Q000601:surgery*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000639:trends; D008297:Male; D000070799:Open Fracture Reduction / Q000639:trends; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
keywords: COPD; Hip fracture; hospitalizations; in-hospital mortality; surgical procedures