The Increase of Osteoporotic Hip Fractures and Associated One-Year Mortality in Poland: 2008-2015

Wojciech Glinkowski, Jerzy Narloch, Krzysztof Krasuski, Andrzej Śliwczyński, Wojciech Glinkowski, Jerzy Narloch, Krzysztof Krasuski, Andrzej Śliwczyński

Abstract

Introduction: Hip fractures are a worldwide public health issue associated with significant mortality. Previous Polish studies reported an increasing trend in the number of hip fractures for both men and women, although lower than most other European countries.

Materials and methods: The Polish National Database was analyzed to examine osteoporotic hip fractures in the population aged 50 and over. Hip fracture incidence, rate, one-year mortality, and postoperative length of hospitalization were analyzed using the national health system data. Hospital discharge registry ICD-10 codes were reviewed from 2008 to 2015.

Results: The incidence of hip fractures increased in both women and men by 19.4% and 14.2%, respectively. The female to male fracture ratio was 2.46. Mean postoperative hospitalization decreased from 13.6 to 11.2 days. The one-year mortality ranged between 30.45% to 32.8% for men and 26.2% to 28% for women. Of note, women aged 80-89 had the highest one-year mortality, 50.7%-55.4% after femoral neck fracture and 53%-58.5% after a pertrochanteric fracture.

Conclusions: Hip fractures in Poland are increasingly more prevalent in the aging population. The unfavorable trends observed in this study indicate higher annual mortality after hip fracture, compared with other European countries.

Keywords: hip; hip fracture; hospitalization; mortality; national; osteoporosis.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Incidence of the femoral neck (FN) and pertrochanteric (PT) fracture in different age groups, compared between men and women, in the years 2008 and 2015.
Figure 2
Figure 2
Percentage of the femoral neck (FN) and pertrochanteric (PT) fractures in age groups 50–79 years vs. ≥80 years.
Figure 3
Figure 3
Percentage of the femoral neck (FN) and pertrochanteric (PT) fractures in all age groups (number of patients placed in bars).
Figure 4
Figure 4
The incidence of the femoral neck (S72.0) and pertrochanteric fracture (S72.1) in men and women during the study period (2008–2015).
Figure 5
Figure 5
Mean hospitalization time due to HF (hip fracture) in men and women during the study period.
Figure 6
Figure 6
Comparison between hospitalization time due to HF (hip fracture) in different age groups at the beginning and end of the study period.
Figure 7
Figure 7
Mean hospitalization time due to the femoral neck (S72.0) and pertrochanteric fracture (S72.1) in men and women during the study period (2008–2015).
Figure 8
Figure 8
Comparison between hospitalization time due to the femoral neck (S72.0) and pertrochanteric fracture (S72.1) in different age groups at the beginning and end of the study period.
Figure 9
Figure 9
Number of deaths within one year after femoral neck (S72.0) and pertrochanteric fracture (S72.1) during the study period.
Figure 10
Figure 10
Number of deaths after one year following femoral neck (S72.0) and pertrochanteric fracture (S72.1) during the study period.
Figure 11
Figure 11
Regression models comparing hospitalization time and the number of deaths within and after one year following HF (hip fracture) during the study period.
Figure 12
Figure 12
Percentage of population aged 50 years or older in Poland during the study period.
Figure 13
Figure 13
1-year mortality percentage after hip fracture—comparison between selected European countries. Calculations for Poland were made based on our data.

References

    1. Papadimitriou N., Tsilidis K.K., Orfanos P., Benetou V., E Ntzani E., Soerjomataram I., Künn-Nelen A., Pettersson-Kymmer U., Eriksson S., Brenner H., et al. Burden of hip fracture using disability-adjusted life-years: A pooled analysis of prospective cohorts in the CHANCES consortium. Lancet Public Health. 2017;2:e239–e246. doi: 10.1016/S2468-2667(17)30046-4.
    1. Klop C., Welsing P.M., Cooper C., Harvey N.C., Elders P.J., Bijlsma J.W., Leufkens H.G., De Vries F. Mortality in British hip fracture patients, 2000–2010: A population-based retrospective cohort study. Bone. 2014;66:171–177. doi: 10.1016/j.bone.2014.06.011.
    1. Liu Y., Wang Z., Xiao W. Risk factors for mortality in elderly patients with hip fractures: A meta-analysis of 18 studies. Aging Clin. Exp. Res. 2018;30:323–330. doi: 10.1007/s40520-017-0789-5.
    1. Wilk R., Skrzypek M., Kowalska M., Kusz D., Koczy B., Zagorski P., Pluskiewicz W. The 13-year observation of hip fracture in Poland-worrying trend and prognosis for the future. Aging Clin. Exp. Res. 2018;30:61–69. doi: 10.1007/s40520-017-0747-2.
    1. Czerwinski E., Kanis J.A., Trybulec B., Johansson H., Borowy P., Osieleniec J. The incidence and risk of hip fracture in Poland. Osteoporos. Int. 2009;20:1363–1367. doi: 10.1007/s00198-008-0787-8.
    1. Kanis J.A., Oden A., McCloskey E.V., Johansson H., Wahl D.A., Cooper C.A. systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos. Int. 2012;23:2239–2256. doi: 10.1007/s00198-012-1964-3.
    1. Yoon B.-H., Lee Y.-K., Kim S.-C., Kim S.-H., Ha Y.-C., Koo K.-H. Epidemiology of proximal femoral fractures in South Korea. Arch. Osteoporos. 2013;8:157. doi: 10.1007/s11657-013-0157-9.
    1. Cordey J., Schneider M., Bühler M. The epidemiology of fractures of the proximal femur. Injury. 2000;31:56–93. doi: 10.1016/S0020-1383(00)80033-9.
    1. Sadat-Ali M., Al-Dakheel D.A., Azam M.Q., Al-Bluwi M.T., Al-Farhan M.F., AlAmer H.A., Al-Meer Z., Al-Mohimeed A., Tabash I.K., Karry M.O., et al. Reassessment of osteoporosis-related femoral fractures and economic burden in Saudi Arabia. Arch. Osteoporos. 2015;10:37. doi: 10.1007/s11657-015-0240-5.
    1. Xia W.B., He S.L., Xu L., Liu A.M., Jiang Y., Li M., Wang O., Xing X.P., Sun Y., Cummings S.R. Rapidly increasing rates of hip fracture in Beijing, China. J. Bone Miner. Res. 2012;27:125–129. doi: 10.1002/jbmr.519.
    1. Emaus N., Olsen L.R., Ahmed L.A., Balteskard L., Jacobsen B.K., Magnus T., Ytterstad B. Hip fractures in a city in Northern Norway over 15 years: Time trends, seasonal variation and mortality: The Harstad Injury Prevention Study. Osteoporos. Int. 2011;22:2603–2610. doi: 10.1007/s00198-010-1485-x.
    1. Statistics Poland Basic Statistics. [(accessed on 31 December 2018)]; Available online: .
    1. Wilk R., Skrzypek M., Kowalska M., Kusz D., Wielgórecki A., Horyniecki M., Śliwiak J., Piejczyk S., Pluskiewicz W. Standardized incidence and trend of osteoporotic hip fracture in Polish women and men: A nine year observation. Maturitas. 2014;77:59–63. doi: 10.1016/j.maturitas.2013.09.004.
    1. Kanis J.A., Johnell O., De Laet C., Jonsson B., Odén A., Ogelsby A.K. International Variations in Hip Fracture Probabilities: Implications for Risk Assessment. J. Bone Miner. Res. 2002;17:1237–1244. doi: 10.1359/jbmr.2002.17.7.1237.
    1. Johnel O., Gullberg B., Allander E., Kanis J.A. The MEDOS Study Group The apparent incidence of hip fracture in Europe: A study of national register sources. Osteoporos. Int. 1992;2:298–302. doi: 10.1007/BF01623186.
    1. Roszkowska H., Goryński P., Wojtyniak B. Hospitalization due to hip fracture in Poland in 1979–1995 by sex, age and place of residence. [pol.] Postępy Osteoartrologii. 1998;10:150–156.
    1. Jaworski M., Lorenc R.S. Risk of hip fracture in Poland. Med. Sci. Monit. 2007;13:CR206–CR210.
    1. Elffors I., Allander E., Kanis J.A., Gullberg B., Johnell O., Dequeker J., Dilsen G., Gennari C., Vaz A.A.L., Lyritis G., et al. The variable incidence of hip fracture in Southern Europe: The MEDOS study. Osteoporos. Int. 1994;4:253–263. doi: 10.1007/BF01623349.
    1. Van Staa T., Dennison E., Leufkens H., Cooper C., Van Staa T. Epidemiology of fractures in England and Wales. Bone. 2001;29:517–522. doi: 10.1016/S8756-3282(01)00614-7.
    1. Ratti C., Vulcano E., La Barbera G., Canton G., Murena L., Cherubino P. The incidence of fragility fractures in Italy. Aging Clin. Exp. Res. 2013;25:13–14. doi: 10.1007/s40520-013-0071-4.
    1. Rapp K., Buchele G., Dreinhofer K., Bucking B., Becker C., Benzinger P. Epidemiology of hip fractures: Systematic literature review of German data and an overview of the international literature. Z. Gerontol. Geriatr. 2018 doi: 10.1007/s00391-018-1382-z.
    1. Mann E., Meyer G., Haastert B., Icks A. Comparison of hip fracture incidence and trends between Germany and Austria 1995–2004: An epidemiological study. BMC Public Health. 2010;10:46. doi: 10.1186/1471-2458-10-46.
    1. Sund R., Riihimäki J., Mäkelä M., Vehtari A., Lüthje P., Huusko T., Häkkinen U. Modeling the length of the care episode after hip fracture: Does the type of fracture matter? Scand. J. Surg. 2009;98:169–174. doi: 10.1177/145749690909800308.
    1. Medin E., Goude F., Melberg H.O., Tediosi F., Belicza É., Peltola M. on behalf of the EuroHOPE study group European Regional Differences in All-Cause Mortality and Length of Stay for Patients with Hip Fracture. Health Econ. 2015;24:53–64. doi: 10.1002/hec.3278.
    1. Fenton J.J., Jerant A.F., Bertakis K.D., Franks P. The cost of satisfaction: A national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch. Intern. Med. 2012;172:405–411. doi: 10.1001/archinternmed.2011.1662.
    1. Currie C. Hip fracture audit: Creating a ‘critical mass of expertise and enthusiasm for hip fracture care’? Injury. 2018;49:1418–1423. doi: 10.1016/j.injury.2018.06.025.
    1. Johansen A., Golding D., Brent L., Close J., Gjertsen J.-E., Holt G., Hommel A., Pedersen A.B., Röck N.D., Thorngren K.-G. Using national hip fracture registries and audit databases to develop an international perspective. Injury. 2017;48:2174–2179. doi: 10.1016/j.injury.2017.08.001.
    1. Cundall-Curry D.J., Lawrence J.E., Fountain D.M., Gooding C.R. Data errors in the National Hip Fracture Database: A local validation study. Bone Joint J. 2016;98:1406–1409. doi: 10.1302/0301-620X.98B10.37089.
    1. Voeten S., Krijnen P., Voeten D., Hegeman J., Wouters M., Schipper I. Quality indicators for hip fracture care, a systematic review. Osteoporos. Int. 2018;29:1963–1985. doi: 10.1007/s00198-018-4558-x.
    1. Voeten S.C., Arends A.J., Wouters M.W.J.M., Blom B.J., Heetveld M.J., Slee-Valentijn M.S., Krijnen P., Schipper I.B., Hegeman J.H., Arends A.J. The Dutch Hip Fracture Audit: Evaluation of the quality of multidisciplinary hip fracture care in the Netherlands. Arch. Osteoporos. 2019;14:28. doi: 10.1007/s11657-019-0576-3.
    1. Macdonald V., Maher A.B., Mainz H., Meehan A.J., Brent L., Hommel A., Hertz K., Taylor A., Sheehan K.J. Developing and Testing an International Audit of Nursing Quality Indicators for Older Adults With Fragility Hip Fracture. Orthop. Nurs. 2018;37:115–121. doi: 10.1097/NOR.0000000000000431.
    1. Mattisson L., Bojan A., Enocson A. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: Data from the Swedish fracture register. BMC Musculoskelet. Disord. 2018;19:369. doi: 10.1186/s12891-018-2276-3.
    1. Iacovino J.R. Mortality outcomes after osteoporotic fractures in men and women. J. Insur. Med. 2001;33:316–320.
    1. Ftouh S., Morga A., Swift C. Management of hip fracture in adults: Summary of NICE guidance. BMJ. 2011;342:d3304. doi: 10.1136/bmj.d3304.
    1. Nordström P., Gustafson Y., Michaëlsson K., Nordström A. Length of hospital stay after hip fracture and short term risk of death after discharge: A total cohort study in Sweden. BMJ. 2015;350:h696. doi: 10.1136/bmj.h696.
    1. Nikkel L.E., Kates S.L., Schreck M., Maceroli M., Mahmood B., Elfar J.C. Length of hospital stay after hip fracture and risk of early mortality after discharge in New York state: Retrospective cohort study. BMJ. 2015;351:h6246. doi: 10.1136/bmj.h6246.
    1. Dubljanin-Raspopović E., Marković-Denić L., Marinkovic J., Nedeljković U., Bumbaširević M. Does Early Functional Outcome Predict 1-year Mortality in Elderly Patients With Hip Fracture? Clin. Orthop. Relat. Res. 2013;471:2703–2710. doi: 10.1007/s11999-013-2955-1.
    1. Heyes G.J., Tucker A., Marley D., Foster A. Predictors for Readmission up to 1 Year Following Hip Fracture. Arch. Trauma Res. 2015;4 doi: 10.5812/atr.4(2)2015.27123.
    1. Kanis J., Oden A., Johnell O., De Laet C., Jonsson B., Oglesby A. The components of excess mortality after hip fracture. Bone. 2003;32:468–473. doi: 10.1016/S8756-3282(03)00061-9.
    1. Karampampa K., Ahlbom A., Michaëlsson K., Andersson T., Drefahl S., Modig K. Declining incidence trends for hip fractures have not been accompanied by improvements in lifetime risk or post-fracture survival—A nationwide study of the Swedish population 60years and older. Bone. 2015;78:55–61. doi: 10.1016/j.bone.2015.04.032.
    1. Cooper C., Atkinson E.J., Jacobsen S.J., O’Fallon W.M., Melton L.J., 3rd Population-based study of survival after osteoporotic fractures. Am. J. Epidemiol. 1993;137:1001–1005. doi: 10.1093/oxfordjournals.aje.a116756.
    1. Leibson C.L., Tosteson A.N.A., Gabriel S.E., Ransom J.E., Melton L.J. Mortality, Disability, and Nursing Home Use for Persons with and without Hip Fracture: A Population-Based Study. J. Am. Geriatr. Soc. 2002;50:1644–1650. doi: 10.1046/j.1532-5415.2002.50455.x.
    1. Keene G.S., Parker M.J., Pryor G.A. Mortality and morbidity after hip fractures. BMJ. 1993;307:1248–1250. doi: 10.1136/bmj.307.6914.1248.
    1. Smith T., Pelpola K., Ball M., Ong A., Myint P.K. Pre-operative indicators for mortality following hip fracture surgery: A systematic review and meta-analysis. Age Ageing. 2014;43:464–471. doi: 10.1093/ageing/afu065.
    1. Söderqvist A., Ekström W., Ponzer S., Pettersson H., Cederholm T., Dalén N., Hedström M., Tidermark J. Prediction of Mortality in Elderly Patients with Hip Fractures: A Two-Year Prospective Study of 1944 Patients. Gerontology. 2009;55:496–504. doi: 10.1159/000230587.
    1. Pioli G., Barone A., Giusti A., Oliveri M., Pizzonia M., Razzano M., Palummeri E. Predictors of mortality after hip fracture: Results from 1-year follow-up. Aging Clin. Exp. Res. 2006;18:381–387. doi: 10.1007/BF03324834.
    1. Magaziner J., Simonsick E.M., Kashner T.M., Hebel J.R., Kenzora J.E. Predictors of Functional Recovery One Year Following Hospital Discharge for Hip Fracture: A Prospective Study. J. Gerontol. 1990;45:101–107. doi: 10.1093/geronj/45.3.M101.
    1. Riggs B.L., Melton L.J., 3rd The worldwide problem of osteoporosis: Insights afforded by epidemiology. Bone. 1995;17:505S–511S. doi: 10.1016/8756-3282(95)00258-4.
    1. Haentjens P., Autier P., Barette M., Venken K., Vanderschueren D., Boonen S. Survival and functional outcome according to hip fracture type: A one-year prospective cohort study in elderly women with an intertrochanteric or femoral neck fracture. Bone. 2007;41:958–964. doi: 10.1016/j.bone.2007.08.026.
    1. Haentjens P., Autier P., Barette M., Boonen S., Autier P. Predictors of functional outcome following intracapsular hip fracture in elderly women. Injury. 2005;36:842–850. doi: 10.1016/j.injury.2005.02.002.
    1. Barette M., Vanderschueren D., Lips P., Haentjens P., Boonen S., Autier P. Functional outcome and quality of life following hip fracture in elderly women: A prospective controlled study. Osteoporos. Int. 2004;15:87–94. doi: 10.1007/s00198-003-1515-z.
    1. Wilk R., Skrzypek M., Kowalska M., Kusz D., Koczy B., Zagorski P., Pluskiewicz W. Do we need orthogeriatrics in Poland? Changes in the age structure and location of hip fractures. Aging Clin. Exp. Res. 2017;29:737–743. doi: 10.1007/s40520-016-0627-1.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa