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Osteoporosis International

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01-01-2015 | Original Article

The incidence of hip fractures in Estonia, 2005–2012

Authors: M. Jürisson, S. Vorobjov, R. Kallikorm, M. Lember, A. Uusküla

Published in: Osteoporosis International | Issue 1/2015

Abstract

Summary

The incidence of hip fractures among individuals aged over 50 in Estonia and trends over time were assessed for 2005–2012. The incidence among women is relatively low, with the declining trend, but the rate among men is among the highest in Eastern and Central Europe.

Introduction

The aim of this study was to assess the incidence and trends of hip fractures among individuals over 50 years in Estonia in 2005–2012 and to increase understanding of the incidence of hip fractures in Eastern Europe.

Methods

We identified all patients aged 50 years or older with hip fracture (ICD-10 codes S72.0, S72.1 and S72.2) in 2005–2012 using medical claims data from the Estonian Health Insurance Fund. Crude and age-specific incidence rates were calculated for men and women using the population of Estonia in 2005–2012. To adjust for age differences in the population, standardized incidence rates (SIR) were estimated.

Results

The SIR per 100,000 for the entire observation period was 209.2 (95 % CI 204.2 to 214.2) in women and 215.6 (95 %CI 208.2 to 223.1) in men, resulting in a female to male rate ratio of 0.97 (95 % CI 0.84 to 1.11). Over the period of 2005–2012 the estimated SIR/100,000 ranged from 211.5 (95 % CI 196.8–226.3) in 2005 to 183.7 (95 % CI 170.8–196.7) in 2012 in women, and from 238.5 (95 % CI 215.4–261.7) in 2005 to 187.9 (95 % CI 169.0–206.8) in 2012, in men. For women, the decrease in SIR for the study period approached statistical significance (p = 0.058), and for the period of 2009–2012, we observed an accelerated 16 % decrease (p = 0.008).

Conclusions

The incidence of hip fractures among Estonian women is relatively low, whereas the rate among men is among the highest in Eastern and Central Europe. In line with many countries, we found a recent decline in incidence among women.

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Melton LJ (2003) Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 18:1139–41. doi:10.1359/jbmr.2003.18.6.1139 PubMedCrossRef

Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–33. doi:10.1007/s00198-006-0172-4 PubMedCrossRef

Johnell O, Kanis JA, Odén A et al (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42. doi:10.1007/s00198-003-1490-4 PubMedCrossRef

Borgstrom F, Lekander I, Ivergard M et al (2013) The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)—quality of life during the first 4 months after fracture. Osteoporos Int 24:811–23. doi:10.1007/s00198-012-2240-2 PubMedCrossRef

Ström O, Borgström F, Kanis JA et al (2011) Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155. doi:10.1007/s11657-011-0060-1 PubMedCrossRef

Abrahamsen B, van Staa T, Ariely R et al (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 20:1633–50. doi:10.1007/s00198-009-0920-3 PubMedCrossRef

Haentjens P, Magaziner J, Colón-Emeric CS et al (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152:380–390. doi:10.1059/0003-4819-152-6-201003160-00008.Meta-analysis PubMedCentralPubMedCrossRef

Cheng S, Levy A, Lefaivre K (2011) Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int 22:2575–2586. doi:10.1007/s00198-011-1596-z PubMedCrossRef

Kanis JA, Borgström F, Compston J et al (2013) SCOPE: a scorecard for osteoporosis in Europe. Arch Osteoporos 8:144. doi:10.1007/s11657-013-0144-1 PubMedCentralPubMedCrossRef

10.

Kanis JA, Odén A, McCloskey E (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–56. doi:10.1007/s00198-012-1964-3 PubMedCentralPubMedCrossRef

11.

Cooper C, Cole ZA, Holroyd CR et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–88. doi:10.1007/s00198-011-1601-6 PubMedCentralPubMedCrossRef

12.

Brauer C, Coca-Perraillon M (2009) Incidence and mortality of hip fractures in the United States. JAMA 302:1573–1579PubMedCrossRef

13.

Abrahamsen B, Vestergaard P (2010) Declining incidence of hip fractures and the extent of use of anti-osteoporotic therapy in Denmark 1997–2006. Osteoporos Int 21:373–380. doi:10.1007/s00198-009-0957-3 PubMedCrossRef

14.

Støen RO, Nordsletten L, Meyer HE et al (2012) Hip fracture incidence is decreasing in the high incidence area of Oslo, Norway. Osteoporos Int 23:2527–34. doi:10.1007/s00198-011-1888-3 PubMedCrossRef

15.

Korhonen N, Niemi S, Parkkari J et al (2013) Continuous decline in incidence of hip fracture: nationwide statistics from Finland between 1970 and 2010. Osteoporos Int 24:1599–603. doi:10.1007/s00198-012-2190-8 PubMedCrossRef

16.

Siggeirsdottir K, Aspelund T, Jonsson BY et al (2014) Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989–2008. Osteoporos Int 25:211–9. doi:10.1007/s00198-013-2422-6 PubMedCrossRef

17.

Nilson F, Moniruzzaman S, Gustavsson J, Andersson R (2013) Trends in hip fracture incidence rates among the elderly in Sweden 1987-2009. J Public Health (Oxf) 35:125–31. doi:10.1093/pubmed/fds053 CrossRef

18.

Icks A, Arend W, Becker C et al (2013) Incidence of hip fractures in Germany, 1995–2010. Arch Osteoporos 8:140. doi:10.1007/s11657-013-0140-5 PubMedCrossRef

19.

Wilk R, Skrzypek M, Kowalska M et al (2013) Standardized incidence and trend of osteoporotic hip fracture in Polish women and men: a nine year observation. Maturitas 77:59–63. doi:10.1016/j.maturitas.2013.09.004 PubMedCrossRef

20.

Tamulaitiene M, Alekna V (2012) Incidence and direct hospitalisation costs of hip fractures in Vilnius, capital of Lithuania, in 2010. BMC Public Health 12:495. doi:10.1186/1471-2458-12-495 PubMedCentralPubMedCrossRef

21.

Lesnyak O, Ershova O, Belova K et al (2012) Epidemiology of fracture in the Russian Federation and the development of a FRAX model. Arch Osteoporos 7:67–73. doi:10.1007/s11657-012-0082-3 PubMedCrossRef

22.

Estonian Health Insurance Fund. http://www.haigekassa.ee/. Accessed 5 Mar 2014

23.

Lix L, Azimaee M, Osman B (2012) Osteoporosis-related fracture case definitions for population-based administrative data. BMC Public Health 12:301PubMedCentralPubMedCrossRef

24.

Statistics Estonia. http://www.stat.ee/. Accessed 5 Mar 2014

25.

World (WHO 2000–2025) standard - Standard Populations - SEER Datasets. http://seer.cancer.gov/stdpopulations/world.who.html. Accessed 9 Mar 2014

26.

Eurostat. http://epp.eurostat.ec.europa.eu/portal/page/portal/eurostat/home/. Accessed 9 Mar 2014

27.

Ahlborg HG, Rosengren BE, Järvinen TLN et al (2010) Prevalence of osteoporosis and incidence of hip fracture in women—secular trends over 30 years. BMC Musculoskelet Disord 11:48PubMedCentralPubMedCrossRef

28.

Grigorie D, Sucaliuc A, Johansson H et al (2013) Incidence of hip fracture in Romania and the development of a Romanian FRAX model. Calcif Tissue Int 92:429–36. doi:10.1007/s00223-013-9697-7 PubMedCrossRef

29.

Dimai HP, Svedbom A, Fahrleitner-Pammer A et al (2011) Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 22:685–92. doi:10.1007/s00198-010-1271-9 PubMedCrossRef

30.

Bjørgul K, Reikerås O (2007) Incidence of hip fracture in southeastern Norway: a study of 1,730 cervical and trochanteric fractures. Int Orthop 31:665–9. doi:10.1007/s00264-006-0251-3 PubMedCentralPubMedCrossRef

31.

Singer BR, McLauchlan GJ, Robinson CM, Christie J (1998) Epidemiology of fractures in 15 000 adults: the influence of age and gender. J Bone Jt Surg Br 80-B:243–248CrossRef

32.

Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. doi:10.1007/s11657-013-0136-1 PubMedCentralPubMedCrossRef

33.

Péntek M, Horváth C, Boncz I et al (2008) Epidemiology of osteoporosis related fractures in Hungary from the nationwide health insurance database, 1999–2003. Osteoporos Int 19:243–9. doi:10.1007/s00198-007-0453-6 PubMedCrossRef

34.

Dodds MK, Codd MB, Looney A, Mulhall KJ (2009) Incidence of hip fracture in the Republic of Ireland and future projections: a population-based study. Osteoporos Int 20:2105–10. doi:10.1007/s00198-009-0922-1 PubMedCrossRef

35.

Ettinger B, Black DM, Dawson-Hughes B et al (2010) Updated fracture incidence rates for the US version of FRAX. Osteoporos Int 21:25–33. doi:10.1007/s00198-009-1032-9 PubMedCentralPubMedCrossRef

36.

Piscitelli P, Chitano G, Johannson H et al (2013) Updated fracture incidence rates for the Italian version of FRAX®. Osteoporos Int 24:859–66. doi:10.1007/s00198-012-2021-y PubMedCrossRef

37.

Maravic M, Taupin P, Landais P, Roux C (2011) Change in hip fracture incidence over the last 6 years in France. Osteoporos Int 22:797–801. doi:10.1007/s00198-010-1255-9 PubMedCrossRef

38.

Stepan JJ, Vaculik J, Pavelka K et al (2012) Hip fracture incidence from 1981 to 2009 in the Czech Republic as a basis of the country-specific FRAX model. Calcif Tissue Int 90:365–72. doi:10.1007/s00223-012-9582-9 PubMedCrossRef

39.

Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674. doi:10.1007/s001980070064 PubMedCrossRef

40.

Tekkel M, Veideman T (2013) Health behaviour among Estonian adult population. In: Heal. Behav. among Est. Adult Popul. https://intra.tai.ee/images/prints/documents/136479842690_TKU_2012.pdf. Accessed 9 Mar 2014

41.

Johnell O, Borgstrom F, Jonsson B, Kanis JA (2007) Latitude, socioeconomic prosperity, mobile phones and hip fracture risk. Osteoporos Int 18:333–7. doi:10.1007/s00198-006-0245-4 PubMedCrossRef

42.

Kull M, Kallikorm R, Tamm A, Lember M (2009) Seasonal variance of 25-(OH) vitamin D in the general population of Estonia, a Northern European country. BMC Public Health 9:22. doi:10.1186/1471-2458-9-22 PubMedCentralPubMedCrossRef

43.

Wahl DA, Cooper C, Ebeling PR et al (2012) A global representation of vitamin D status in healthy populations. Arch Osteoporos 7:155–72. doi:10.1007/s11657-012-0093-0 PubMedCrossRef

44.

Kuchuk NO, van Schoor NM, Pluijm SM et al (2009) Vitamin D status, parathyroid function, bone turnover, and BMD in postmenopausal women with osteoporosis: global perspective. J Bone Miner Res 24:693–701. doi:10.1359/jbmr.081209 PubMedCrossRef

45.

Jørgensen TSH, Hansen AH, Sahlberg M, et al. (2014) Falls and comorbidity: the pathway to fractures. Scand J Public Health 1403494813516831–. doi: 10.1177/1403494813516831

46.

Health statistics and health research database. http://pxweb.tai.ee/esf/pxweb2008/dialog/statfile1.asp. Accessed 9 Mar 2014

47.

Berg KM, Kunins HV, Jackson JL et al (2008) Association between alcohol consumption and both osteoporotic fracture and bone density. Am J Med 121:406–18. doi:10.1016/j.amjmed.2007.12.012 PubMedCentralPubMedCrossRef

48.

Kanis JA, Johansson H, Johnell O et al (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–42. doi:10.1007/s00198-004-1734-y PubMedCrossRef

49.

Popova S, Rehm J, Patra J, Zatonski W (2007) Comparing alcohol consumption in central and eastern Europe to other European countries. Alcohol Alcohol 42:465–73. doi:10.1093/alcalc/agl124 PubMedCrossRef

50.

Lim SS, Vos T, Flaxman AD et al (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2224–60. doi:10.1016/S0140-6736(12)61766-8 PubMedCentralPubMedCrossRef

51.

Global Burden of Disease (GBD) Visualizations | Institute for Health Metrics and Evaluation. http://www.healthmetricsandevaluation.org/gbd/visualizations/country. Accessed 9 Mar 2014

52.

Sabre L, Pedai G, Rekand T et al (2012) High incidence of traumatic spinal cord injury in Estonia. Spinal Cord 50:755–9. doi:10.1038/sc.2012.54 PubMedCrossRef

53.

Karagas MR, Lu-Yao GL, Barrett JA et al (1996) Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US Elderly. Am J Epidemiol 143:677–682. doi:10.1093/oxfordjournals.aje.a008800 PubMedCrossRef

54.

Ryg J, Rejnmark L, Overgaard S et al (2009) Hip fracture patients at risk of second hip fracture: a nationwide population-based cohort study of 169,145 cases during 1977–2001. J Bone Miner Res 24:1299–307. doi:10.1359/jbmr.090207 PubMedCrossRef

Title: The incidence of hip fractures in Estonia, 2005–2012
Authors: M. Jürisson
S. Vorobjov
R. Kallikorm
M. Lember
A. Uusküla
Publication date: 01-01-2015
Publisher: Springer London
Published in: Osteoporosis International / Issue 1/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-014-2820-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The incidence of hip fractures in Estonia, 2005–2012

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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