Hip fractures cluster in space: an epidemiological analysis in Portugal

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Pina MF (Author) FMUP; Alves S (Author) Other; Barbosa M (Author) FEUP; Barros H (Author) FMUP

Journal

Title: Osteoporosis International

Vol. 19

Pages: 1797-1804

ISSN: 0937-941X

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 36 Citations

Scopus - 37 Citations

Pubmed / Medline

Scientific classification

FOS: Medical and Health sciences > Health sciences

Other information

Authenticus ID: P-003-TPX

DOI: 10.1007/s00198-008-0623-1

Abstract (EN): Using Portuguese hospital registers (2000-2002) we calculated age-standardized incidence rates of hip fractures. Spatial clusters of high incidence rates were found, with annual averages (per 100,000 inhabitants) varying from 154.4 to 572.2 and 77.3 to 231.5 for women and men, respectively. Geographic inequalities in the occurrence of hip fractures were also found. Introduction The aim of this study was to identify spatial patterns in the incidence of hip fracture in Portugal during the period 2000 to 2002. Methods From the National Hospital Discharge Register, admissions of patients (50 years of age or more) with low-energy hip fracture were selected. Age-standardized incidence rates in relation to the municipality of the patients' place of residence were calculated. Empirical Bayes estimators were used to smooth the local risk and spatial statistics methods were used to identify spatial clusters. Results Of 25,634 hip fractures in individuals aged 50 years or more caused by low or moderate impact, 19,759 occurred in women (age, mean +/- SD, 80.6 +/- 8.6 years) and 5,875 in men (age 77.7 +/- 10.0 years). Incidence rates increased exponentially with age, being higher in women nation-wide (female to male ratio from 1.5 to 5.1). Significant geographic differences were found: the incidence rates (95% CI) varied from 154.4 (153.6-155.3) to 572.2 (569.5-575.0) in women and 77.3 (76.64-78.05) to 231.5 (229.9-233.0) in men per 100,000 inhabitants. Spatial autocorrelation values (Moran index) were 0.56 and 0.45 for women and men, respectively. Conclusion Spatial clusters (p < 0.0001) of high incidences were identified. Geographic differences in incidence rates were about threefold. Some regions had incidence rates as high as some north European countries. The geographic inequalities could be due to environmental or socioeconomic factors, but further investigation needs to be done to confirm this hypothesis.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8