Epidemiology and economic burden of fragility fractures in Austria

Abstract

Fragility fractures are a frequent and costly event. In Austria, 92,835 fragility fractures occurred in patients aged ≥ 50 years in 2018, accruing direct costs of > 157 million €. Due to demographic aging, the number of fragility fractures and their associated costs are expected to increase even further. Introduction Fragility fractures are frequently associated with long hospital stays, loss of independence, and increased need for care in the elderly, with consequences often leading to premature death. The aim of this study was to estimate the number of fragility fractures and associated healthcare costs in Austria in 2018. Methods The number of in-patient cases with relevant ICD-10 diagnoses in all Austrian public hospitals was derived from discharge documentation of diagnoses and procedures covering all public hospitals in Austria. Fractures resulting from falls from standing height in patients aged ≥ 50 years were used as a proxy for fragility fractures, and the number of in-patient and out-patient cases was estimated. The direct costs of these cases were calculated using the average cost of the corresponding in-patient hospital stay and the average cost for the out-patient stay. ResultsThe present study estimated the number of fragility fractures (pelvis, thoracic and lumbar vertebra, hip, humerus, rib, forearm, and tibia) for 2018 at 92,835 or just over half of all fractures in patients aged ≥ 50 years, corresponding to a prevalence of 2,600 per 100,000 inhabitants of this age group. A constant increase in the proportion of fragility fractures among all fractures was observed with increasing age in both men and women. These fractures amounted to direct costs of > 157 million €. Conclusion Fragility fractures are a frequent and costly event in Austria. Due to the aging of the population, the number of fragility fractures and their associated costs is expected to increase even further.

Impact of Physical Rehabilitation on Bone Biomarkers in Non-Metastatic Breast Cancer Women: A Systematic Review and Meta-Analysis

“…To the best of our knowledge, this is the first systematic review focusing on the effects of different exercise modalities on bone biomarkers in non-metastatic BC survivors. In the era of precision medicine, a biomarker-based approach might have a role in improving the comprehensive rehabilitation management of these women, including not only physical exercise, but also antiresorptive drugs in patients at high risk of fracture to maximize outcomes and reduce the disability and socio-sanitary costs of fragility fractures [ 69 , 70 , 71 ]. In addition, due to the widely documented effects of physical exercise on oxidative stress and inflammation, a precise multitarget rehabilitation intervention might not only improve bone health, but also have potential interaction with malignant transformation and tumor progression pathways in BC patients [ 72 , 73 , 74 , 75 , 76 ].…”

Pelvic Fractures—An Underestimated Problem? Incidence and Mortality Risk after Pelvic Fracture in Austria, 2010–2018

“…On the other hand, the limitation of this study is that only patients treated in hospitals were included. As shown in a recent work by Muschitz et al, the estimated volume of ambulatory-treated PFs in Austria is nearly twice that of hospital-based treated cases [ 21 ]. We were limited by our data to clearly answering the question of whether post-pelvic-fracture mortality is attributable to pre-existing comorbidities or to the fracture itself.…”

“…This study was a nationwide retrospective register-based observational study that included all patients in Austria aged ≥50 from nine former health insurance providers, representing 76% of the insured population in Austria. The cutoff point of 50 years was based on the fact that the incidence of low-traumatic fractures significantly increases from the age of 50 years [ 21 ]. The lifetime risk for a 50-year-old woman to suffer an osteoporotic fracture is 50%.…”

Epidemiologie der Osteoporose

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