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Published in: Osteoporosis International 1/2013

01-01-2013 | Original Article

A decreasing trend in fall-related hip fracture incidence in Victoria, Australia

Authors: E. Cassell, A. Clapperton

Published in: Osteoporosis International | Issue 1/2013

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Abstract

Summary

In Victoria, Australia, the age-standardised incidence of fall-related hip fracture hospitalisations decreased significantly by 25% over the period 1998/1999–2008/2009. Significant decreases in fall-related hip fractures were observed in males and females, across all 5-year age groups, in Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people.

Introduction

The study aim was to investigate trends in the incidence of fall-related and hip fracture hospitalisations among Victorians aged 65 years and older overall and by age, gender, country of birth, socio-economic status (SES) and location of the event (home, residential care institution, etc.) over the 11-year period 1998/1999 to 2008/2009.

Methods

Annual counts and age-standardised rates for fall-related hospitalisations among people aged 65 years and older were estimated using Victorian hospital admissions data. The statistical significance of changes in trends over time were analysed using a log-linear regression model of the rate data assuming a Poisson distribution of cases.

Results

Although the age-standardised incidence of fall-related hospitalisations increased significantly by 13% (95% confidence interval [CI], 9% to 18%) in Victoria, the age-standardised incidence of fall-related hip fracture hospitalisations decreased from 600/100,000 in 1998/1999 to 467/100,000 in 2008/2009 — an estimated overall reduction of 25% (95% CI, −29% to −22%). By contrast, the age-standardised incidence of fall-related hospitalisations for fractures at other body sites either increased significantly or showed no significant change. Significant decreases in fall-related hip fractures were observed in both males and females, across all 5-year age groups, in both Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people but not in people living in residential care facilities.

Conclusion

Despite the downward trend in the age-standardised incidence of fall-related hip fractures in Victoria, the burden of fall-related and hip fracture hospitalisations on health care systems and the community is set to escalate due to the ageing of the Victorian population.
Literature
1.
go back to reference Cummings SR, Melton LJ 3rd (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRef Cummings SR, Melton LJ 3rd (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRef
2.
go back to reference Sanders KM, Nicholson GC, Ugoni AM, Pasco JA, Seeman E, Kotowicz MA (1999) Health burden of hip and other fractures in Australia beyond 2000. Projections based on the Geelong Osteoporosis Study. Med J Aust 170(10):467–470PubMed Sanders KM, Nicholson GC, Ugoni AM, Pasco JA, Seeman E, Kotowicz MA (1999) Health burden of hip and other fractures in Australia beyond 2000. Projections based on the Geelong Osteoporosis Study. Med J Aust 170(10):467–470PubMed
3.
go back to reference Australian Institute of Health and Welfare (2010) The problem of osteoporotic hip fracture in Australia. AIHW bulletin no. 76. Cat. no. AUS 121. AIHW, Canberra Australian Institute of Health and Welfare (2010) The problem of osteoporotic hip fracture in Australia. AIHW bulletin no. 76. Cat. no. AUS 121. AIHW, Canberra
4.
go back to reference Cassell E, Clapperton A (2010) Fall injury prevention in Victoria, Australia—progress against predictions. Presented at the 4th Australian and New Zealand Falls Prevention Society Conference. 21–23 November 2010, Dunedin, New Zealand Cassell E, Clapperton A (2010) Fall injury prevention in Victoria, Australia—progress against predictions. Presented at the 4th Australian and New Zealand Falls Prevention Society Conference. 21–23 November 2010, Dunedin, New Zealand
5.
go back to reference Pasco JA, Brennan SL, Henry MJ, Nicholson GC, Sanders KM, Zhang Y, Kotowicz MA (2011) Changes in hip fracture rates in southeastern Australia spanning the period 1994–2007. J Biomed Mater Res 26(7):1648–1654 Pasco JA, Brennan SL, Henry MJ, Nicholson GC, Sanders KM, Zhang Y, Kotowicz MA (2011) Changes in hip fracture rates in southeastern Australia spanning the period 1994–2007. J Biomed Mater Res 26(7):1648–1654
6.
go back to reference Watson WL, Mitchell R (2010) Conflicting trends in fall-related injury hospitalisations among older people: variations by injury type. Osteoporos Int 22(10):2623–2631PubMedCrossRef Watson WL, Mitchell R (2010) Conflicting trends in fall-related injury hospitalisations among older people: variations by injury type. Osteoporos Int 22(10):2623–2631PubMedCrossRef
7.
go back to reference Cassell E, Clapperton A (2008) Preventing injury in Victorian seniors aged 65 years and older. Hazard 67:1–21, Victorian Injury Surveillance Unit Cassell E, Clapperton A (2008) Preventing injury in Victorian seniors aged 65 years and older. Hazard 67:1–21, Victorian Injury Surveillance Unit
8.
go back to reference Fisher AA, O’Brien ED, David MW (2009) Trends in hip fracture epidemiology in Australia: possible impact of bisphosphonates and hormone replacement therapy. Bone 45(2):246–253PubMedCrossRef Fisher AA, O’Brien ED, David MW (2009) Trends in hip fracture epidemiology in Australia: possible impact of bisphosphonates and hormone replacement therapy. Bone 45(2):246–253PubMedCrossRef
9.
go back to reference Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302(14):1573–1579PubMedCrossRef Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302(14):1573–1579PubMedCrossRef
10.
go back to reference Leslie WD, O’Donnell S, Jean S, Lagacé C, Walsh P, Bancej C, Morin S, Hanley DA, Papaioannou A (2009) Trends in hip fracture rates in Canada. JAMA 302(8):883–889PubMedCrossRef Leslie WD, O’Donnell S, Jean S, Lagacé C, Walsh P, Bancej C, Morin S, Hanley DA, Papaioannou A (2009) Trends in hip fracture rates in Canada. JAMA 302(8):883–889PubMedCrossRef
11.
go back to reference Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jävinen M (2006) Nationwide decline in incidence of hip fractures. J Bone Miner Res 21(12):1836–1838PubMedCrossRef Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jävinen M (2006) Nationwide decline in incidence of hip fractures. J Bone Miner Res 21(12):1836–1838PubMedCrossRef
12.
go back to reference Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, Chandran M, Borgström F (2010) Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 22(2):685–692PubMedCrossRef Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, Chandran M, Borgström F (2010) Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 22(2):685–692PubMedCrossRef
13.
go back to reference Langley J, Samaranayaka A, Davie G, Campbell AJ (2010) Age, cohort and period effects on hip fracture incidence: analysis and predictions from New Zealand data 1974–2007. Osteoporos Int 22(1):105–111, Epub 2010 Mar 23PubMedCrossRef Langley J, Samaranayaka A, Davie G, Campbell AJ (2010) Age, cohort and period effects on hip fracture incidence: analysis and predictions from New Zealand data 1974–2007. Osteoporos Int 22(1):105–111, Epub 2010 Mar 23PubMedCrossRef
14.
go back to reference Wu TY, Jen MH, Bottle A, Liaw CK, Aylin P, Majeed A (2010) Admission rates and in-hospital mortality for hip fractures in England 1998 to 2009: time trends study. J Publ Health 33(2):284–291CrossRef Wu TY, Jen MH, Bottle A, Liaw CK, Aylin P, Majeed A (2010) Admission rates and in-hospital mortality for hip fractures in England 1998 to 2009: time trends study. J Publ Health 33(2):284–291CrossRef
15.
go back to reference Hernández JL, Olmos JM, Alonso MA, González-Fernández CR, Martínez J, Pajarón M, Llorca J, González-Macías J (2006) Trend in hip fracture epidemiology over a 14-year period in a Spanish population. Osteoporos Int 17:464–470PubMedCrossRef Hernández JL, Olmos JM, Alonso MA, González-Fernández CR, Martínez J, Pajarón M, Llorca J, González-Macías J (2006) Trend in hip fracture epidemiology over a 14-year period in a Spanish population. Osteoporos Int 17:464–470PubMedCrossRef
16.
go back to reference Icks A, Haastert B, Wildner M, Becker C, Meyer G (2008) Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 19:1139–1145PubMedCrossRef Icks A, Haastert B, Wildner M, Becker C, Meyer G (2008) Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 19:1139–1145PubMedCrossRef
17.
go back to reference Piscitelli P, Gimigliano F, Gatto S, Marinelli A, Gimigliano A, Marinelli P, Chitano G, Greco M, Di Paola L, Sbenaglia E, Benvenuto M, Muratore M, Quarta E, Calcagnile F, Colí G, Borgia O, Forcina B, Fitto F, Giordano A, Distante A, Rossini M, Angeli A, Migliore A, Guglielmi G, Guida G, Brandi ML, Gimigliano R, Iolascon G (2010) Hip fractures in Italy: 2000–2005 extension study. Osteoporos Int 21:1323–1330PubMedCrossRef Piscitelli P, Gimigliano F, Gatto S, Marinelli A, Gimigliano A, Marinelli P, Chitano G, Greco M, Di Paola L, Sbenaglia E, Benvenuto M, Muratore M, Quarta E, Calcagnile F, Colí G, Borgia O, Forcina B, Fitto F, Giordano A, Distante A, Rossini M, Angeli A, Migliore A, Guglielmi G, Guida G, Brandi ML, Gimigliano R, Iolascon G (2010) Hip fractures in Italy: 2000–2005 extension study. Osteoporos Int 21:1323–1330PubMedCrossRef
18.
go back to reference National Centre for Classification in Health (2006) International statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM), 5th edn. National Centre for Classification in Health, Sydney National Centre for Classification in Health (2006) International statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM), 5th edn. National Centre for Classification in Health, Sydney
19.
go back to reference Gibson D, Braun P, Benham C, Mason F (2001) Projections of older immigrants: people from culturally and linguistically diverse backgrounds, 1996–2026, Australia. AIHW cat. no. AGE 18. Australia Institute of Health and Welfare (Aged Care Series no. 6), Canberra Gibson D, Braun P, Benham C, Mason F (2001) Projections of older immigrants: people from culturally and linguistically diverse backgrounds, 1996–2026, Australia. AIHW cat. no. AGE 18. Australia Institute of Health and Welfare (Aged Care Series no. 6), Canberra
20.
go back to reference Australian Bureau of Statistics (2008) Socio-Economic Indexes for Areas (SEIFA) — Technical Paper, 2006. ABS Catalogue no. 2039.0.55.001. Canberra Australian Bureau of Statistics (2008) Socio-Economic Indexes for Areas (SEIFA) — Technical Paper, 2006. ABS Catalogue no. 2039.0.55.001. Canberra
21.
go back to reference SAS Institute (2003) SAS: statistical software, version 9.1. SAS Institute, Cary SAS Institute (2003) SAS: statistical software, version 9.1. SAS Institute, Cary
22.
go back to reference Jamieson LM, Roberts-Thomson KF (2007) Hospitalized head injuries among older people in Australia, 1998/1999–2004/05. Inj Prev 13:243–247PubMedCrossRef Jamieson LM, Roberts-Thomson KF (2007) Hospitalized head injuries among older people in Australia, 1998/1999–2004/05. Inj Prev 13:243–247PubMedCrossRef
23.
go back to reference Rizzoli R, Akesson M, Bouxsein M, Kanis JA, Napoli N, Papapoulos S, Reginster JY, Cooper C (2011) Subtrochanteric fractures after long-term treatment with bisphosphonates: a European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, and International Osteoporosis Foundation Working Group Report. Osteoporos Int 22:373–390PubMedCrossRef Rizzoli R, Akesson M, Bouxsein M, Kanis JA, Napoli N, Papapoulos S, Reginster JY, Cooper C (2011) Subtrochanteric fractures after long-term treatment with bisphosphonates: a European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, and International Osteoporosis Foundation Working Group Report. Osteoporos Int 22:373–390PubMedCrossRef
24.
go back to reference Abrahamsen B, Eiken P, Eastell R (2010) Cumulative alendronate dose and the long-term absolute risk of subtrochanteric and diaphyseal femur fractures: a register-based national cohort analysis. J Clin Endocrinol Metab 95(12):5258–5265PubMedCrossRef Abrahamsen B, Eiken P, Eastell R (2010) Cumulative alendronate dose and the long-term absolute risk of subtrochanteric and diaphyseal femur fractures: a register-based national cohort analysis. J Clin Endocrinol Metab 95(12):5258–5265PubMedCrossRef
25.
go back to reference Nymark T, Lauritsen JM, Ovesen O, Röck ND, Jeune B (2006) Decreasing incidence of hip fracture in the Funen County, Denmark. Acta Orthop 77(1):109–113PubMedCrossRef Nymark T, Lauritsen JM, Ovesen O, Röck ND, Jeune B (2006) Decreasing incidence of hip fracture in the Funen County, Denmark. Acta Orthop 77(1):109–113PubMedCrossRef
26.
go back to reference Maravic M, Taupin P, Landais P, Roux C (2010) Change in hip fracture incidence over the last 6 years in France. Osteoporos Int 22(3):797–801PubMedCrossRef Maravic M, Taupin P, Landais P, Roux C (2010) Change in hip fracture incidence over the last 6 years in France. Osteoporos Int 22(3):797–801PubMedCrossRef
27.
go back to reference Holt G, Smith R, Duncan K, Hutchison JD, Reid D (2009) Changes in population demographics and the future incidence of hip fracture. Injury 40(7):722–726PubMedCrossRef Holt G, Smith R, Duncan K, Hutchison JD, Reid D (2009) Changes in population demographics and the future incidence of hip fracture. Injury 40(7):722–726PubMedCrossRef
28.
go back to reference Löfman O, Berglund K, Larrson L, Toss G (2002) Changes in hip fracture epidemiology: redistribution between ages, genders and fracture types. Osteoporos Int 13:18–25PubMedCrossRef Löfman O, Berglund K, Larrson L, Toss G (2002) Changes in hip fracture epidemiology: redistribution between ages, genders and fracture types. Osteoporos Int 13:18–25PubMedCrossRef
29.
go back to reference Guilley E, Chevalley T, Herrmann F, Baccino D, Hoffmeyer P, Rapin CH, Rizzoli R (2008) Reversal of the hip fracture secular trend is related to a decrease in the incidence in institution-dwelling elderly women. Osteoporos Int 19(12):1741–1747PubMedCrossRef Guilley E, Chevalley T, Herrmann F, Baccino D, Hoffmeyer P, Rapin CH, Rizzoli R (2008) Reversal of the hip fracture secular trend is related to a decrease in the incidence in institution-dwelling elderly women. Osteoporos Int 19(12):1741–1747PubMedCrossRef
31.
go back to reference Clapperton A, Cassell E (2009) The impact of area socioeconomic inequity on serious injury in Victoria. Hazard 70:1–29, Victorian Injury Surveillance Unit Clapperton A, Cassell E (2009) The impact of area socioeconomic inequity on serious injury in Victoria. Hazard 70:1–29, Victorian Injury Surveillance Unit
32.
go back to reference Gillespie L, Handoll H (2009) Prevention of falls and fall-related injuries in older people. Inj Prev 15:354–355PubMedCrossRef Gillespie L, Handoll H (2009) Prevention of falls and fall-related injuries in older people. Inj Prev 15:354–355PubMedCrossRef
33.
go back to reference Jarvinen TLN, Sievanen H, Khan KM, Heinonen A, Kannus P (2008) Shifting the focus in fracture prevention from osteoporosis to falls. BMJ 336:124–126PubMedCrossRef Jarvinen TLN, Sievanen H, Khan KM, Heinonen A, Kannus P (2008) Shifting the focus in fracture prevention from osteoporosis to falls. BMJ 336:124–126PubMedCrossRef
34.
go back to reference Emkey RD, Ettinger M (2006) Improving compliance and persistence with bisphosphonate therapy for osteoporosis. Am J Med 119(4A):18S–24SCrossRef Emkey RD, Ettinger M (2006) Improving compliance and persistence with bisphosphonate therapy for osteoporosis. Am J Med 119(4A):18S–24SCrossRef
35.
go back to reference Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ (2007) Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc 82:1493–1501PubMedCrossRef Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ (2007) Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc 82:1493–1501PubMedCrossRef
36.
go back to reference Australian Institute of Health and Welfare (2007) Older Australia at a glance, 4th edn. Cat. No. AGE52. AIHW, Canberra Australian Institute of Health and Welfare (2007) Older Australia at a glance, 4th edn. Cat. No. AGE52. AIHW, Canberra
37.
go back to reference Australian Institute of Health and Welfare (2011) National Drug Strategy Household Survey report. Drug statistics series no. 25. Cat. No. PHE 145. AIHW, Canberra Australian Institute of Health and Welfare (2011) National Drug Strategy Household Survey report. Drug statistics series no. 25. Cat. No. PHE 145. AIHW, Canberra
38.
go back to reference Vu T, Finch CF, Day L (2011) Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: a cluster analysis. BMC Geriatr 11:45PubMedCrossRef Vu T, Finch CF, Day L (2011) Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: a cluster analysis. BMC Geriatr 11:45PubMedCrossRef
39.
go back to reference Australian Institute of Health and Welfare (2011) Projections of the incidence of treated end-stage kidney disease in Australia Cat. no. PHE 150. AIHW, Canberra Australian Institute of Health and Welfare (2011) Projections of the incidence of treated end-stage kidney disease in Australia Cat. no. PHE 150. AIHW, Canberra
40.
go back to reference Australian Institute of Health and Welfare (2010) Australia’s health 2010. Australia’s health no. 12. Cat. no. AUS 122. AIHW, Canberra Australian Institute of Health and Welfare (2010) Australia’s health 2010. Australia’s health no. 12. Cat. no. AUS 122. AIHW, Canberra
41.
go back to reference Australian Institute of Health and Welfare, Bennett SA, Magnus P, Gibson D (2004) Obesity trends in older Australians. Bulletin no. 12. AIHW cat. No. 42. AIHW, Canberra Australian Institute of Health and Welfare, Bennett SA, Magnus P, Gibson D (2004) Obesity trends in older Australians. Bulletin no. 12. AIHW cat. No. 42. AIHW, Canberra
42.
43.
go back to reference Migliaccio S, Greco EA, Fornari R et al (2011) Is obesity in women protective against osteoporosis? Diabetes, metabolic syndrome and obesity: targets and therapy. Diabetes Metab Syndr Obes 4:273–282PubMedCrossRef Migliaccio S, Greco EA, Fornari R et al (2011) Is obesity in women protective against osteoporosis? Diabetes, metabolic syndrome and obesity: targets and therapy. Diabetes Metab Syndr Obes 4:273–282PubMedCrossRef
44.
go back to reference Douchi T, Yamamoto S, Kuwahata R, Oki T, Yamasaki H, Nagata Y (2000) Effect of non-weight bearing body fat on one mineral density before and after menopause. Obstet Gynecol 96(1):13–17PubMedCrossRef Douchi T, Yamamoto S, Kuwahata R, Oki T, Yamasaki H, Nagata Y (2000) Effect of non-weight bearing body fat on one mineral density before and after menopause. Obstet Gynecol 96(1):13–17PubMedCrossRef
45.
go back to reference Judd HL, Shamonki IM, Frumar AM, Lagasse LD (1982) Origin of serum estradiol in postmenopausal women. Obstet Gynecol 59(6):680–686PubMed Judd HL, Shamonki IM, Frumar AM, Lagasse LD (1982) Origin of serum estradiol in postmenopausal women. Obstet Gynecol 59(6):680–686PubMed
46.
go back to reference Lang T, Koyama A, Li C et al (2008) Pelvic body composition measurements by quantitative computed tomography: association with recent hip fracture. Bone 42:798–805PubMedCrossRef Lang T, Koyama A, Li C et al (2008) Pelvic body composition measurements by quantitative computed tomography: association with recent hip fracture. Bone 42:798–805PubMedCrossRef
Metadata
Title
A decreasing trend in fall-related hip fracture incidence in Victoria, Australia
Authors
E. Cassell
A. Clapperton
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 1/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-012-1937-6

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