Ten years of hip fractures in Italy: For the first time a decreasing trend in elderly women.

AIM To evaluate the hospitalization rate of femoral neck fractures in the elderly Italian population over ten years. METHODS We analyzed national hospitalizations records collected at central level by the Ministry of Health from 2000 to 2009. Age- and sex-specific rates of fractures occurred at femoral neck in people ≥ 65 years old. We performed a sub-analysis over a three-year period (2007-2009), presenting data per five-year age groups, in order to evaluate the incidence of the hip fracture in the oldest population. RESULTS We estimated a total of 839008 hospitalizations due to femoral neck fractures between 2000 and 2009 in people ≥ 65, with an overall increase of 29.8% over 10 years. The incidence per 10000 inhabitants remarkably increased in people ≥ 75, passing from 158.5 to 166.8 (+5.2%) and from 72.6 to 77.5 (+6.8%) over the ten-year period in women and men, respectively. The oldest age group (people > 85 years old) accounted for more than 42% of total hospital admissions in 2009 (n = 39000), despite representing only 2.5% of the Italian population. Particularly, women aged > 85 accounted for 30.8% of total fractures, although they represented just 1.8% of the general population. The results of this analysis indicate that the incidence of hip fractures progressively increased from 2000 to 2009, but a reduction can be observed for the first time in women ≤ 75 (-7.9% between 2004 and 2009). CONCLUSION Incidence of hip fractures in Italy are continuously increasing, although women aged 65-74 years old started showing a decreasing trend.

[1]  P. Vestergaard,et al.  [Strongly increasing incidence of hip fractures in Denmark from 1977 to 1999]. , 2008, Ugeskrift for laeger.

[2]  D. Torgerson,et al.  The Cost of Treating Osteoporotic Fractures in the United Kingdom Female Population , 1998, Osteoporosis International.

[3]  G. Meyer,et al.  Hip fracture incidence in the elderly in Austria: An epidemiological study covering the years 1994 to 2006 , 2008, BMC geriatrics.

[4]  A. Distante,et al.  Hip fractures in Italy: 2000–2005 extension study , 2010, Osteoporosis International.

[5]  J. Bentin,et al.  Costs Induced by Hip Fractures: A Prospective Controlled Study in Belgium , 2000, Osteoporosis International.

[6]  C. Cooper,et al.  The crippling consequences of fractures and their impact on quality of life. , 1997, The American journal of medicine.

[7]  A. Distante,et al.  [Incidence and socioeconomic burden of hip fractures in Italy: extension study 2003-2005]. , 2011, Reumatismo.

[8]  F. Connell,et al.  Hip Fracture Incidence in Nursing Home Residents and Community‐Dwelling Older People, Washington State, 1993–1995 , 2002, Journal of the American Geriatrics Society.

[9]  C. Cooper,et al.  A systematic review of hip fracture incidence and probability of fracture worldwide , 2012, Osteoporosis International.

[10]  A. Distante,et al.  Incidence and costs of hip fractures compared to acute myocardial infarction in the Italian population: a 4-year survey , 2007, Osteoporosis International.

[11]  M. Brandi,et al.  The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study , 2010, Arthritis research & therapy.

[12]  B. Gullberg,et al.  The apparent incidence of hip fracture in Europe: A study of national register sources , 1992, Osteoporosis International.

[13]  J. Kanis,et al.  Updated fracture incidence rates for the Italian version of FRAX® , 2013, Osteoporosis International.

[14]  J. Llorca,et al.  Trend in hip fracture epidemiology over a 14-year period in a Spanish population , 2005, Osteoporosis International.

[15]  J. A. Kanis,et al.  European guidance for the diagnosis and management of osteoporosis in postmenopausal women , 2013, Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA.

[16]  G. Iolascon,et al.  Femoral fractures and orthopaedic surgery: a 4-year survey in Italy , 2005, Journal of Orthopaedics and Traumatology.

[17]  J. Reginster,et al.  Estimation of direct unit costs associated with non-vertebral osteoporotic fractures in five European countries , 2005, Rheumatology International.

[18]  L. Melton,et al.  Medical Expenditures for the Treatment of Osteoporotic Fractures in the United States in 1995: Report from the National Osteoporosis Foundation , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[19]  S. Cummings,et al.  Secular trends in the incidence of hip and other osteoporotic fractures , 2011, Osteoporosis International.