Good news, bad news for global hip fracture rates

AUSTIN, Texas – The incidence of hip fractures has decreased in many parts of the world, but an aging population is likely to impede this positive pathway, a researcher reports.

Based on an evaluation of 20 healthcare databases from 19 regions and states, the rate of hip fractures has decreased by up to 2.8% per year in 11 global regions, according to Douglas Keel, MD, MPH, of Beth Israel Deaconess Medical Center/Harvard Medical School in Boston. .

However, it is estimated that the number of these fractions will double by 2050, notably with a 4.5-fold increase in the global population of people aged -85 (based on an analysis of the years 2010-2050), Kiel and colleagues, including Chur- Wing Seng, Ph.D., from the University of Hong Kong, reported in American Society for Bone and Mineral Research (ASBMR) Meeting.

In addition, there was a “significant post-fracture treatment gap in fracture prevention in all countries during the study period” from 2005 to 2018, and they state that “several potential causes of this gap include concerns about adverse events associated with antifracture therapies,” the Kiel Group He pointed out.

He also indicated that the burden of hip fractures was more pronounced in men than in women, and that there was a higher mortality rate among men. For the latter, the authors reported that all-cause mortality within a year of experiencing a hip fracture ranged from 19.2% to 35.8% among men versus 12.1% to 25.4% among women.

Regarding the treatment gap, Keel explained that in the UK database, 50.3% of patients surveyed, who were within one year of experiencing a hip fracture, reported receiving prophylactic treatment, which was the best outcome of any area included in the study. In the United States, 35% of patients reported the same. In other countries, the cure rate after fractures was as low as 11%.

Databases used in the retrospective cohort study included electronic health records from a hospital or primary care practice, billing claims, and national data. In some countries, data is available for up to 100% of the population; In other countries, the data represented anywhere from 5% to 70% of the population, according to the authors. The Kiel group looked at the incidence of hip fractures in people over 50 years old. Study protocol described in 2021 BMJ is open Article – commodity.

The authors reported that in the Medicare database, the incidence of hip fractures during the study period was 487.9 per 100,000 population (over 65 years of age). In other countries, the incidence rate was 315.9 per 100,000 people in Denmark, 95.1 in Brazil, and 54.8 in Japan (those under 75 years of age).

They said rates of hip fractures in people over 85 were twice as high as rates in the 80-84 age group.

“The message from this epidemiological study is: We have to figure out why there is such a treatment gap, that only 50% of patients with a history of fractures are treated to prevent osteoporosis and other fractures,” said ASBMR session co-facilitator Radhika Narla, MD. , of the University of Washington/Veteran Affairs Puget Sound in Seattle.

“We have a lot of work to do,” she said. MedPage todaysuggesting that most people in the study who had already suffered a hip fracture should have been treated with newer medications, such as biologics or bisphosphonates, yet the study showed poor absorption of these drugs in this population.

Disclosures

The study was funded by Amgen.

Kel, Singh, and Narla have not disclosed any ties to the industry.

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