Epidemiology of hip fracture and the development of a FRAX model for Uzbekistan

Abstract Summary A prospective population-based survey in a region of the Republic of Uzbekistan determined the incidence of fractures at the hip. The hip fracture rates were used to create a FRAX® model to facilitate fracture risk assessment in Uzbekistan. Objective This paper describes the epidemiology of hip fracture in the Republic of Uzbekistan that was used to develop a country-specific FRAX® tool for fracture prediction. Methods During a 1-year (2016/17) prospective population-based survey in the Pap district of the Republic of Uzbekistan, hip fractures were prospectively identified from hospital registers, trauma centres and primary care and community sources. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Uzbekistan. Fracture probabilities were compared with those from neighbouring Kazakhstan and Kyrgystan. Results Approximately 41% of hip fracture cases did not come to medical attention, and two thirds of patients overall were not admitted to hospital. The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 16,764 and is predicted to increase more than three-fold to 60,272 in 2050. FRAX-based probabilities were higher in Uzbekistan than Kazakhstan or Kyrgystan. Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Uzbek population and help guide decisions about treatment.

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Epidemiology of osteoporotic fracture in Moldova and development of a country-specific FRAX model

Archives of Osteoporosis ◽

10.1007/s11657-019-0669-z ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 6

Author(s):

Alla Zakroyeva ◽

Olga Lesnyak ◽

Victor Cazac ◽

Liliana Groppa ◽

Eugen Russu ◽

...

Keyword(s):

Hip Fracture ◽

Osteoporotic Fractures ◽

Population Based ◽

Fracture Probability ◽

Republic Of Moldova ◽

National Mortality ◽

The Republic ◽

Specific Fracture ◽

Country Specific ◽

Population Based Survey

Abstract Summary Retrospective population-based survey in 2 regions of the Republic of Moldova determined the incidence of fractures at the hip, proximal humerus and distal forearm. The estimated number of such fractures nationwide for 2015 was 11,271 and is predicted to increase to 15,863 in 2050. The hip fracture rates were used to create a FRAX model to help guide decisions about treatment. Objective This paper describes the epidemiology of osteoporotic fractures in Republic of Moldova that was used to develop the country-specific fracture prediction FRAX® tool. Methods We carried out a retrospective population-based survey in 2 regions of the Republic of Moldova (Anenii Noi district and Orhei district) representing approximately 6% of the country’s population. We identified hip, forearm and humerus fractures in 2011 and 2012 from hospital registers and primary care sources. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Moldova. Fracture probabilities were compared with those from neighbouring countries having FRAX models. Results The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 3911 and is predicted to increase by 60% to 6492 in 2050. Hip fracture incidence was a good predictor of forearm and humeral fractures. FRAX-based probabilities were higher in Moldova than neighbouring countries (Ukraine and Romania). Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Moldavan population and help guide decisions about treatment.

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Epidemiology of hip fractures in Bulgaria: development of a country-specific FRAX model

Archives of Osteoporosis ◽

10.1007/s11657-020-0710-2 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

E. Kirilova ◽

H. Johansson ◽

N. Kirilov ◽

S. Vladeva ◽

T. Petranova ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Population Based ◽

Fracture Probability ◽

Regional Health ◽

National Mortality ◽

Bulgarian Population ◽

Specific Fracture ◽

Country Specific ◽

Population Based Survey

Abstract Summary A retrospective population-based survey was undertaken in a region of Bulgaria to determine the incidence of hip fracture. The estimated number of hip fractures nationwide for 2015 was 9322 and is predicted to increase to 11,398 in 2050. The hip fracture rates were used to create a FRAX model. Objective To describe the epidemiology of hip fractures in Bulgaria, which was then used to develop the country-specific fracture prediction FRAX® tool. Methods We carried out a retrospective population-based survey in Stara Zagora, Bulgaria, representing approximately 4.6% of the country’s population. We identified hip fractures occurring in 2015, 2016 and 2017 from hospital registers and primary care sources held by the regional health insurance agency. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Bulgaria. Fracture probabilities were compared with those from neighbouring countries having FRAX models. Results The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 9322 and is predicted to increase to 11,398 in 2050. FRAX-based probabilities were higher in Bulgaria than those in Serbia or Romania, lower than those in Turkey and similar to those in Greece. Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Bulgarian population and help guide decisions about treatment.

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Epidemiology of osteoporotic fracture in Kazakhstan and development of a country specific FRAX model

Archives of Osteoporosis ◽

10.1007/s11657-020-0701-3 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 4

Author(s):

S. Issayeva ◽

O. Lesnyak ◽

A. Zakroyeva ◽

B. Issayeva ◽

D. Dilmanova ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Osteoporotic Fractures ◽

Population Based ◽

Trauma Centre ◽

Fracture Incidence ◽

Hip Fracture Incidence ◽

The Republic ◽

Country Specific ◽

Population Based Survey

Abstract Summary Retrospective and prospective population-based survey in a region of the Republic of Kazakhstan determined the incidence of fractures at the hip, proximal humerus and distal forearm. The hip fracture rates were used to create a FRAX® model to enhance fracture risk assessment in Kazakhstan. Objective This paper describes the epidemiology of osteoporotic fractures in the Republic of Kazakhstan that was used to develop a country specific FRAX® tool for fracture prediction. Methods We carried out a retrospective population-based survey in Taldykorgan in the Republic of Kazakhstan representing approximately 1% of the country’s population. Hip, forearm and humerus fractures were identified retrospectively in 2015 and 2016 from hospital registers and the trauma centre. Hip fractures were prospectively identified in 2017 from the same sources and additionally from primary care data. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Kazakhstan. Fracture probabilities were compared with those from neighbouring countries having FRAX models. Results The difference in hip fracture incidence between the retrospective and prospective survey indicated that approximately 25% of hip fracture cases did not come to hospital attention. The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 11,690 and is predicted to increase by 140% to 28,000 in 2050. Hip fracture incidence was a good predictor of forearm and humeral fractures in men but not in women. Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Kazakh population and help guide decisions about treatment.

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Epidemiology of hip fracture in Botswana

Archives of Osteoporosis ◽

10.1007/s11657-021-00885-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

M. Kebaetse ◽

S. Nkhwa ◽

M. Mogodi ◽

J. Masunge ◽

Y. P. Gureja ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Chart Review ◽

Population Based ◽

Men And Women ◽

Patient Chart ◽

Number Of Patients ◽

The Republic ◽

Age And Sex ◽

Population Based Survey

Abstract Summary A retrospective population-based survey in the Republic of Botswana determined the incidence of fractures at the hip over 3 years. The estimated number of such fractures nationwide for 2020 was 103 and is predicted to increase. Objective This article describes the epidemiology of hip fractures in the Republic of Botswana. Methods A retrospective patient chart review was conducted to identify from hospital registers the number of patients diagnosed with hip fracture in 2009, 2010, and 2011. Age- and sex-specific incidence of hip fracture was determined from which lifetime probabilities and future projections for hip fracture were calculated. Results The incidence of hip fracture was low and comparable to rates reported from Tunisia. The remaining lifetime risk of hip fracture at the age of 50 years in men and women was 1.4 and 1.1%, respectively. The incidence of hip fracture suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2020 was 103 and is predicted to increase by more than threefold to 372 in 2050. Conclusion The hip fracture rates can be used for healthcare planning. Additionally, these data can be used to create a FRAX model to help guide decisions about treatment.

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A country-specific FRAX model for Botswana

Archives of Osteoporosis ◽

10.1007/s11657-021-00965-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

M. Kebaetse ◽

S. Nkhwa ◽

M. Mogodi ◽

J. Masunge ◽

Y. P. Gureja ◽

...

Keyword(s):

Risk Assessment ◽

Hip Fracture ◽

Fragility Fractures ◽

Mortality Rates ◽

African Countries ◽

Major Osteoporotic Fracture ◽

National Mortality ◽

Prevention And Treatment ◽

The Usa ◽

Country Specific

Abstract Introduction Hip fracture rates in Botswana were used to create a FRAX® model for fracture risk assessment. Objective This paper describes the development and characteristics of a country-specific FRAX model for Botswana. Methods Age-specific and sex-specific incidence of hip fracture and national mortality rates was incorporated into a FRAX model for Botswana. Ten-year fracture probabilities were compared with those from African countries having a FRAX model and African Americans from the USA. Results The probabilities of hip fracture and major osteoporotic fracture were low compared with those from South Africa (Black and Coloured) and US Blacks. Probabilities were marginally higher than for Tunisia. Conclusion The creation of a FRAX model is expected to help guide decisions about the prevention and treatment of fragility fractures in Botswana.

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A surrogate FRAX model for Pakistan

Archives of Osteoporosis ◽

10.1007/s11657-021-00894-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

G. Naureen ◽

H. Johansson ◽

R. Iqbal ◽

L. Jafri ◽

A. H. Khan ◽

...

Keyword(s):

Hip Fracture ◽

Rank Order ◽

Mortality Rates ◽

Fracture Probability ◽

Mortality Data ◽

Men And Women ◽

Death Risk ◽

Specific Mortality ◽

Indian Men ◽

Country Specific

Abstract Summary A surrogate FRAX® model for Pakistan has been constructed using age-specific hip fracture rates for Indians living in Singapore and age-specific mortality rates from Pakistan. Introduction FRAX models are frequently requested for countries with little or no data on the incidence of hip fracture. In such circumstances, the International Society for Clinical Densitometry and International Osteoporosis Foundation have recommended the development of a surrogate FRAX model, based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country. Objective This paper describes the development and characteristics of a surrogate FRAX model for Pakistan. Methods The FRAX model used the ethnic-specific incidence of hip fracture in Indian men and women living in Singapore, combined with the death risk for Pakistan. Results The surrogate model gave somewhat lower 10-year fracture probabilities for men and women at all ages compared to the model for Indians from Singapore, reflecting a higher mortality risk in Pakistan. There were very close correlations in fracture probabilities between the surrogate and authentic models (r ≥ 0.998) so that the use of the Pakistan model had little impact on the rank order of risk. It was estimated that 36,524 hip fractures arose in 2015 in individuals over the age of 50 years in Pakistan, with a predicted increase by 214% to 114,820 in 2050. Conclusion The surrogate FRAX model for Pakistan provides an opportunity to determine fracture probability within the Pakistan population and help guide decisions about treatment.

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EPIDEMIOLOGY OF FRACTURES OF THE PROXIMAL FEMUR IN ELDERLY RESIDENTS OF YAKUTSK

Osteoporosis and Bone Diseases ◽

10.14341/osteo201539-12 ◽

2015 ◽

Vol 18 (3) ◽

pp. 9-12

Author(s):

V V Epanov ◽

A K Lebedev ◽

A A Epanova ◽

I P Semenov ◽

G A Palshin ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Bone Fractures ◽

Osteoporotic Fractures ◽

Population Based ◽

Incidence Rates ◽

Fracture Incidence ◽

Hip Fracture Incidence ◽

The Republic ◽

A Minor

Bone fractures of the skeleton with a minor injury is a clinical manifestation of osteoporosis and its population-based marker. The incidence of hip fracture varies in different geographic areas and ethnic groups. The aim was to study incidence of hip fractures in patients older than 40 years in the Republic of Sakha (Yakutia, Russian federation) in 2011-2013 and to compare the data with the previous study at the same region performed in 1997-2003. Material and methods. The study is a part of a multi-center international project «Epidemiological study of osteoporotic fractures in Eurasia (EVA).» It was a retrospective study followed by a prospective one. In the retrospective part the information on hip fracture cases registered in the official documents of the orthopedic service in 2011-2012 was collected. The prospective part was conducted in 2013, it was aimed at the identification of the patients with a hip fracture, applied not only in orthopedic department but also to other medical professionals, such as general practitioners. Results. Overall, in three years 426 hip fractures were reported in the city of Yakutsk. The total number of fractures in women was 286 (67.1%), in men - 140 (32.9%). We observed the increase in hip fracture incidence in 2013 (192 cases per 100,000 population in men and 283 per 100,000 in women 50 years old and older) which was 12% higher than in 2011 and 2012. We owe it to improved registration of hip fractures in the group of women 85 years old and older. The hip fracture incidence in this study significantly exceed the data of previous study 15 years ago. Conclusion. In recent years, there is an increase in incidence rates of hip fracture in Yakutsk due to improved hospitalization rates in orthopedic service.

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Searching for the ‘winner’ hip fracture patient: the effect of modifiable and non-modifiable factors on clinical outcomes following hip fracture surgery

Hip International ◽

10.1177/1120700019878814 ◽

2019 ◽

pp. 112070001987881 ◽

Cited By ~ 1

Author(s):

Konstantinos G Makridis ◽

Leonidas S Badras ◽

Stelios L Badras ◽

Theofilos S Karachalios

Keyword(s):

Quality Of Life ◽

Hip Fracture ◽

Medical Treatment ◽

Clinical Outcomes ◽

Hip Fractures ◽

Mortality Rates ◽

Factors Affecting ◽

Modifiable Factors ◽

Modifiable Factor

Background: Various factors, other than the quality of surgery, may influence clinical outcomes of hip fracture patients. We aimed to evaluate the relative impact of several factors on functional outcome, quality of life, re-fracture and mortality rates following surgery for hip fractures. Methods: We studied 498 (62.2%) women and 302 (37.8%) men with a mean age of 81.3 years (range, 60–95) with hip fractures (femoral neck and pertrochanteric). The mean follow-up was 74 months (range 58–96). Various patient-related and surgery-related parameters were recorded and correlated to both objective and subjective mobility, functional recovery and quality of life scales. Mortality and re-fracture rates were also evaluated. Results: Using multiple regression analysis, age >80 years ( p = 0.000; 95% CI, 1.077–1.143) and ASA score III and IV ( p = 0.000; 95% CI, 2.088–3.396) (both non-modifiable factors) both proved to be independent (s.s.) factors affecting mortality rates. Age <80 years ( p = 0.000; 95% CI, 0.932–0.974), surgery delay less (modifiable factor) than 48 hours ( p = 0.046; 95% CI, 0.869–0.999), low dementia CDR index ( p = 0.005; 95% CI, 0.471–0.891) (non-modifiable factor), and osteoporosis medical treatment (modifiable factor) ( p = 0.006; 95% CI, 0.494–0.891) were shown to be independent (s.s.) factors affecting HOOS-symptoms. Osteoporosis medical treatment used proved to be an independent (s.s.) factor affecting HOOS-daily activities ( p = 0.049; 95% CI, 0.563–1.000) and quality of life (E-Qol-5D) ( p = 0.036; 95% CI, 0.737–1.325). Conclusions: A hip fracture patient aged <80 years old, with an ASA I-II, with low dementia CDR index and on osteoporosis medication has a better chance of an improved outcome (winner patient).

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Milk drinking and risk of hip fracture: the Norwegian Epidemiologic Osteoporosis Studies (NOREPOS)

British Journal Of Nutrition ◽

10.1017/s0007114518003823 ◽

2019 ◽

Vol 121 (6) ◽

pp. 709-718 ◽

Cited By ~ 3

Author(s):

Kristin Holvik ◽

Haakon E. Meyer ◽

Ida Laake ◽

Diane Feskanich ◽

Tone K. Omsland ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Cox Regression ◽

Population Based ◽

Third Wave ◽

Hospital Data ◽

High Fracture ◽

Hazard Ratios ◽

Meta Analyses

AbstractMilk provides energy and nutrients considered protective for bone. Meta-analyses of cohort studies have found no clear association between milk drinking and risk of hip fracture, and results of recent studies are contradictory. We studied the association between milk drinking and hip fracture in Norway, which has a population characterised by high fracture incidence and a high Ca intake. Baseline data from two population-based cohorts were used: the third wave of the Norwegian Counties Study (1985–1988) and the Five Counties Study (2000–2002). Diet and lifestyle variables were self-reported through questionnaires. Height and weight were measured. Hip fractures were identified by linkage to hospital data with follow-up through 2013. Of the 35 114 participants in the Norwegian Counties Study, 1865 suffered a hip fracture during 613 018 person-years of follow-up. In multivariable Cox regression, hazard ratios (HR) per daily glass of milk were 0·97 (95 % CI 0·92, 1·03) in men and 1·02 (95 % CI 0·96, 1·07) in women. Of 23 259 participants in the Five Counties Study, 1466 suffered a hip fracture during 252 996 person-years of follow-up. HR for hip fractures per daily glass of milk in multivariable Cox regression was 0·99 (95 % CI 0·92, 1·07) in men and 1·02 (95 % CI 0·97, 1·08) in women. In conclusion, there was no overall association between milk intake and risk of hip fracture in Norwegian men and women.

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Bisphosphonate Use and Hospitalization for Hip Fractures in Women: An Observational Population-Based Study in France

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168780 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8780

Author(s):

Bastien Bourrion ◽

Cécile Souty ◽

Lucie Fournier ◽

Ana-Maria Vilcu ◽

Thierry Blanchon ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Primary Outcome ◽

Real Life ◽

Osteoporotic Fractures ◽

Population Based ◽

Medication Persistence ◽

Population Based Study ◽

Osteoporotic Hip Fracture ◽

Overall Effectiveness

Bisphosphonates are widely used in the treatment of women at risk of osteoporotic hip fracture; however, the overall effectiveness of bisphosphonates in the prevention of osteoporotic fractures has not been studied in real life. To investigate whether the use of bisphosphonates in women aged 50 years and over is associated with a decrease in hospitalization for osteoporotic hip fractures, a historical prospective cohort study was conducted between 2009 and 2016 from a permanent representative sample consisting of 1/97 of the French health insurance beneficiaries. Bisphosphonate use was defined according to medication persistence and adherence regarding bisphosphonate dispensations. The primary outcome was the hospitalization rate for osteoporotic hip fracture. Among the 81,268 women included, 2005 were exposed to bisphosphonates. The median time of bisphosphonate exposure was 12 (IQR, 3–29) and 17 (IQR, 5–42) months for the persistence and adherence definitions, respectively. Exposure to bisphosphonates was not associated with a decrease in hospitalization for hip fracture: weighted HRadherence = 0.66 (95% CI, 0.33 to 1.33); HRpersistance = 0.77 (95% CI, 0.38 to 1.57). In real life, bisphosphonate use does not appear to reduce hospitalization for hip fractures, as to date, it is probably prescribed as primary prevention and for a duration too short to be effective.

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