DOS 2016

· DOS Abstracts

35-year trends in first-time hospitalization for hip

fracture and one year mortality: a Danish nationwide

cohort study, 1980-2014

Alma B Pedersen, Vera Ehrenstein, Szimonetta Szepligeti, Astrid Lunde, Ylva T

Lagerros, Anna Westerlund, Grethe S Tell, Henrik Toft Sørense

Department of Clinical Epidemiology, Aarhus University Hospital;Department

of Global Public Health and Primary Care, University of Bergen; of Clinical

Epidemiology, Karolinska Institutet; Centre of Pharmaoepidemiology, Karolinska

Institutet

Background:

Osteoporosis affects 200 million persons worldwide, with hip

fracture being the most common manifestation of the disease.

Purpose / Aim of Study:

To examine trends in hip fracture incidence in

Denmark from 1980 to 2014, and trends in subsequent one-year mortality by

sex, age, and comorbidity.

Materials and Methods:

Nationwide cohort study based on prospectively

collected Danish registries. Participants: 262,437 patients with incident hip

fracture. Outcomes: Standardized incidence rate of hip fracture; mortality 30

days and 31-365 days after hip fracture. Comorbidity was assessed using the

Charlson Comorbidity Index (CCI) score. We computed mortality rate ratios

(MRRs) using Cox regression.

Findings / Results:

Despite slight increases in incidence rates of hip fracture

up to the mid-1990s, the incidence rate decreased by 29% from 1980 to

2014 in women, but remained stable in men. Rates decreased in persons of all

age groups. The proportion of patients with very severe comorbidity preced-

ing hip fracture increased from 5.6% in 1980-1984 to 26.5% in 2010-2014,

respectively. Adjusted MRRs were 0.7 (95% confidence interval (CI): 0.6-0.7)

within 30 days and 0.6 (95% CI: 0.6-0.7) within 31-365 days of hip fracture in

2010-2014 compared with 1980-1984. Analyses stratified by CCI revealed a

reduction in mortality from 1980 to 2014 both in patients without comorbidity

and in patients with different scores of comorbidity.

Conclusions:

We found a decrease in rates of hip fracture in women, and in

all age groups from 1980 through 2014. Although the proportion of patients

with comorbidity increased twofold to fivefold over time, 30-day and 31-365

day mortality decreased by 30% to 40% over the study period. The decrease in

mortality was seen in patients without and with comorbidity before hip fracture

across calendar periods of hip fracture diagnosis.

No conflicts of interest reported

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