Are there still east-to-west differences in the incidence of hip fractures in Germany?

Defèr, A.; Schober, Hans-Christof; Möhrke, W.; Abendroth, Κ.; Hofbauer, Lorenz C.

doi:10.1007/s11657-014-0195-y

Cited by 6 publications

(7 citation statements)

References 12 publications

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“…Germany is a high-risk country for hip fractures with an incidence of approximately 130 fractures/100,000 citizens per year (standardized to the German population; [ 11 ]). Considerable differences in hip fracture incidence have been reported for the different federal states [ 12 ]. They do not follow an apparent pattern and the underlying reasons remain unclear.…”

Section: Resultsmentioning

confidence: 99%

Epidemiology of hip fractures

et al. 2018

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Background Hip fractures are regarded as a worldwide epidemic and a major public health concern. Changing risk factors, local differences and temporal trends contribute to the particular epidemiology of hip fractures. This overview gives a comprehensive insight into the epidemiology of hip fractures and reviews where German data have contributed to the literature. Methods The review of the epidemiology of hip fractures in Germany is based on a systematic literature search in PubMed. Information about the global epidemiology of hip fractures was provided by a selective literature review focusing on specific aspects of the epidemiology of hip fractures. Results Hip fracture rates vary more than 100-fold between different countries. In most high-income countries, a rise in age-standardized hip fracture rates was observed until the 1980s and 1990s and a decrease thereafter. Such a decrease has not been observed for Germany so far. Many factors, diseases and drugs have been found to be associated with hip fractures and there is some evidence that fracture risk in later life is already programmed during fetal life and early childhood. Of the hip fracture burden 50% occur in people with disability and in need of care. In nursing homes approximately 4 fractures can be expected in 100 women per year. In people with intellectual or developmental disabilities comparable risks of hip fracture occur 10–40 years earlier than in the general population. Incidence of disability, institutionalization and death are frequent consequences of hip fractures. Conclusion The epidemiology of hip fractures is characterized by a high burden of disease, local differences, temporal trends, well-defined high-risk populations and many established risk factors. Electronic supplementary material The online version of this article (10.1007/s00391-018-1382-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Epidemiology of hip fractures

et al. 2018

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“…Des Weiteren konnten signifikante Assoziationen mit dem Alter [8,9] und dem männlichen Geschlecht (2x höhere Chance als Frauen) identifiziert werden [9]. Bundeslandunterschiede konnten bereits für das Auftreten von femoralen Frakturen als auch Frakturen der Rippe(n), des Sternums und der Brustwirbelsäule sowie der Lendenwirbelsäule und des Beckens gezeigt werden [13][14][15]. Interessanterweise traten dabei in Bremen mehr femorale Frakturen pro 100.000 Personen auf, als in Deutschland gesamt [13,14].…”

Section: Resultsunclassified

“…Bundeslandunterschiede konnten bereits für das Auftreten von femoralen Frakturen als auch Frakturen der Rippe(n), des Sternums und der Brustwirbelsäule sowie der Lendenwirbelsäule und des Beckens gezeigt werden 13 14 15 . Interessanterweise traten dabei in Bremen mehr femorale Frakturen pro 100.000 Personen auf, als in Deutschland gesamt 13 14 .…”

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Krankenhaussterbefälle nach proximaler Femurfraktur: eine retrospektive Analyse für Deutschland und die einzelnen Bundesländer

2023

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Zusammenfassung Hintergrund Proximale Frakturen des Femurs sind mit einer starken Einschränkung der Lebensqualität und erhöhten Mortalität assoziiert. Da für Deutschland zur Mortalität nur wenige Daten vorliegen, war das Ziel dieser Analyse die Krankenhaussterberate nach proximaler Femurfraktur für Deutschland, geschlechts- und altersspezifisch sowie für die Bundesländer zu untersuchen. Methoden Es wurden Daten zu proximalen Femurfrakturen aus der InEK-Datenbank unter Berechnung von Odds Ratios (OR), altersstandardisierten Krankenhaussterberaten (AKR) pro 1.000 Frakturfälle sowie dem Vergleich der AKR mittels Standardized Rate Ratios (SRR) für Patient*innen im Alter von≥50 Jahren analysiert. Ergebnisse Die altersstandardisierte Krankenhaussterberate nach proximaler Femurfraktur lag für Deutschland bei 28,5 (95% Konfidenzintervall [95% KI]: 27,4; 29,7) pro 1.000 Frakturen, wobei die Bundesland-spezifischen AKRs zwischen 18,6 (95% KI: 11,1; 26,1; Bremen) und 37,2 (95% KI: 24,8; 49,6; Saarland) pro 1.000 Frakturen lagen. Signifikant höhere AKRs im Vergleich zum Referenzbundesland Bremen konnten für 10 Bundesländer errechnet werden, mit SRRs von 1,46 (95% KI: 1,02; 2,09; Baden-Württemberg) bis 2,00 (95% KI: 1,16; 3,43; Saarland). Des Weiteren hatten in der Analyse für ganz Deutschland Männer eine etwa 2-fach höhere Chance (OR: 1,76 [95% KI: 1,69 1,84]) nach proximaler Femurfraktur im Krankenhaus zu versterben als Frauen. Schlussfolgerung Diese Analyse zeigt, dass Männer eine fast doppelt so hohe Chance haben nach proximaler Femurfraktur im Krankenhaus zu versterben und dass in Deutschland signifikante Bundeslandunterschiede in der AKR vorliegen.

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“…There is evidence for regional variation of hip fracture incidence [7][8][9], but not for regional variation of care dependency after hip fracture. Regional variation of care dependency can be caused by differences in the treatment and care of hip fractures, which can be reflected by demographic or health care supply characteristics of the region.…”

Section: Introductionmentioning

confidence: 94%

“…In a worldwide comparison, Germany has a fairly high incidence of hip fractures, varying between 249/100,000 [2] and 261/100,000 [1]. Likewise, regional variation of hip fracture incidence within Germany has been investigated [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Regional variation of care dependency after hip fracture in Germany: A retrospective cohort study using health insurance claims data

et al. 2020

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ObjectiveTo investigate variation of care dependency after hip fracture across German regions based on the assessment by the German statutory long-term care insurance. Data sources/study settingPatient-level statutory health and long-term care insurance claims data from 2009-2011 and official statistical data from Germany. Study designWe performed a retrospective cohort study. Investigated multinomial outcome categories were increase in care dependency (new onset or a higher care dependency than pre-fracture), no change as reference and death as competing risk in the quarterly period following hip fracture (follow-up 3 months). Regional variation was operationalized with the variance of regional-level random intercepts based on generalized linear mixed models. We adjusted for patient and regional characteristics. Principal findingsThe study included 122,887 hip fracture patients in 95 German postal code regions. Crude outcomes were 30.87% increase in care dependency and 14.35% death. Results indicated modest variation on regional level. Male sex, increasing age, increasing comorbidity, pertrochanteric and subtrochanteric fracture site compared to femoral neck, time from hospital admission to surgery of 3 or more days, as well as increasing inpatient length of stay, nonparticipation in rehabilitation and regions with lower hospital density were positively associated with an increase in care dependency. PLOS ONEPLOS ONE | https://doi.org/10.1371/journal.pone.). In order to fulfill the legal requirements to obtain that kind of data, researchers must obtain a permission for a specific ConclusionsSeveral characteristics on patient and regional level associated with the outcome were identified. Variation in the increase in care dependency after hip fracture appeared to be attributable primarily to patient characteristics. Variation on regional level was only modest.

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Are there still east-to-west differences in the incidence of hip fractures in Germany?

Cited by 6 publications

References 12 publications

Epidemiology of hip fractures

Epidemiology of hip fractures

Krankenhaussterbefälle nach proximaler Femurfraktur: eine retrospektive Analyse für Deutschland und die einzelnen Bundesländer

Regional variation of care dependency after hip fracture in Germany: A retrospective cohort study using health insurance claims data

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