ISR Autumn Meeting 2016

2nd Prize Oral Presentation

Ms Bernie McGowan
The North Western Rheumatology Unit, Our Lady's Hospital, Manorhamilton, Co Leitrim, Ireland

Oral (16A105)

CHANGING TRENDS IN THE INCIDENCE OF HIP AND OTHER OSTEOPOROTIC TYPE FRACTURES IN IRELAND

Author(s)

M.S. Kelly1,B. McGowan1, M. McKenna2, K. Bennett3, B. Whelan1,4, C. Silke1. preprocess

Department(s)/Institutions

1. The North Western Rheumatology Unit, Our Lady's Hospital, Manorhamilton, Co Leitrim, Ireland,

2. St.Vincent's University Hospital, Dublin, Ireland,

3. Dept of Population Health, The Royal College of Surgeons, Dublin 1

4. The Department of Medicine, NUIG preprocess

Introduction

Recent studies have indicated a possible reversal of the secular trend of fractures in many countries across Europe and the USA. Previously, we reported a continuous increase in the incidence of all osteoporotic type fractures in Ireland between 2000 and 2009 with a decrease in the age standardised rates with the exception of the 55-59 year age group[1]. preprocess

Aims/Background

The aims of the study were to continue the trend analyses from 2009 onwards of all hospitalisations for osteoporotic-type fractures in males and females aged 50 years and over in Ireland between 2010 and 2014. A second objective was to project the number of hip fractures in the Republic of Ireland expected by 2046 based on the 2014 incidence data preprocess

Method

Age- and gender-specific trends in the absolute numbers and direct age-standardised rates of hospitalisations for all osteoporotic-type fractures in men and women ≥50 years were analysed along with the associated length of stay using the Hospital In-Patient Enquiry system database. Future projections of absolute numbers of hip fractures in years 2021, 2031, 2041 and 2046 were computed based on the 2014 incidence rates applied to the projected populations. preprocess

Results

Between 2010 and 2014, the absolute numbers of all osteoporotic-type fractures decreased by 0.4% in females and by 3.9 % in males while the absolute numbers of hip fractures increased by 0.2% in women but decreased by 12.8% in males. The age-standardised rates for hip fractures decreased in all age groups in both females and males with the exception of males 85 years and older who showed a 1.8% increase. Assuming stable age-standardised incidence rates from 2014 over the next 30 years, the number of hospitalisations for hip fractures is projected to increase 3 fold from 4,301 in 2014 to 12,708 in 2046. 50% of these hip fracture patients in 2046 will be in the 85 or older age group, increasing from 36% in 2014. preprocess

Conclusions

In contrast to the results of previously published studies on trends in fracture incidence in Ireland [1] the present study identified a stabilising of the trends in the number of hospitalisations for osteoporotic-type fractures in Ireland since 2010. The incidence of hospitalisation for hip fractures decreased by 12.8% in males. The age standardised rates in both women and men also fell with the exception of men aged 85 years. The declining trends may be partly explained by the specific measures taken in recent years in falls prevention in at risk groups and the heightened awareness of osteoporosis in general in Ireland. 

1.      McGowan B , Casey MC, Silke C, Whelan B, Bennet K. Hospitalisations for fracture and associated costs between 2000 and 2009 in Ireland: a trend analysis Osteoporosis International March 2013, Volume 24, Issue 3, pp 849-857 preprocess