Explaining declining hip fracture rates in Norway: a population-based modelling study

Kjeldgaard, Helena Kames; Holvik, Kristin; Abrahamsen, Bo; Tell, Grethe S.; Meyer, Haakon E; O’Flaherty, Martı́n

doi:10.1016/j.lanepe.2023.100643

Cited by 6 publications

(1 citation statement)

References 32 publications

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“…21 Examination of potential reasons behind falling incidence rates in some countries again strongly points to the importance of population-level interventions, such as increased physical activity, reduced smoking rates, and greater uptake of osteoporotic medication prescriptions. 22…”

Section: Discussionmentioning

confidence: 99%

The impact of an ageing population on future increases in hip fracture burden

Harris,

Clement,

MacLullich

et al. 2024

Bone Joint J

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AimsCurrent levels of hip fracture morbidity contribute greatly to the overall burden on health and social care services. Given the anticipated ageing of the population over the coming decade, there is potential for this burden to increase further, although the exact scale of impact has not been identified in contemporary literature. We therefore set out to predict the future incidence of hip fracture and help inform appropriate service provision to maintain an adequate standard of care.MethodsHistorical data from the Scottish Hip Fracture Audit (2017 to 2021) were used to identify monthly incidence rates. Established time series forecasting techniques (Exponential Smoothing and Autoregressive Integrated Moving Average) were then used to predict the annual number of hip fractures from 2022 to 2029, including adjustment for predicted changes in national population demographics. Predicted differences in service-level outcomes (length of stay and discharge destination) were analyzed, including the associated financial cost of any changes.ResultsBetween 2017 and 2021, the number of annual hip fractures increased from 6,675 to 7,797 (15%), with a rise in incidence from 313 to 350 per 100,000 (11%) for the at-risk population. By 2029, a combined average projection forecast the annual number of hip fractures at 10,311, with an incidence rate of 463 per 100,000, representing a 32% increase from 2021. Based upon these projections, assuming discharge rates remain constant, the total overall length of hospital stay following hip fracture in Scotland will increase by 60,699 days per annum, incurring an additional cost of at least £25 million per year. Approximately five more acute hip fracture beds may be required per hospital to accommodate this increased activity.ConclusionProjection modelling demonstrates that hip fracture burden and incidence will increase substantially by 2029, driven by an ageing population, with substantial implications for health and social care services.Cite this article: Bone Joint J 2024;106-B(1):62–68.

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Section: Discussionmentioning

confidence: 99%

The impact of an ageing population on future increases in hip fracture burden

Harris,

Clement,

MacLullich

et al. 2024

Bone Joint J

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The hip fracture incidence in the high-risk area Oslo continues to decline

Hestnes,

Solberg,

Meyer

et al. 2024

Osteoporos Int

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Summary Oslo in Norway has had the highest incidence of hip fractures in the world. The incidence in Oslo has been thoroughly described every decade since the late 1970s. The incidence in Oslo has previously been higher compared to the rest of Norway but has now decreased to a level below the country average. Purpose The purpose of this study was to report the incidence of hip fractures in Oslo in 2019 and compare it with the incidence rates from the previous four decades. Methods Patients residing in Oslo in 2019 with a new hip fracture identified by searching the Oslo hospital’s patient administrative systems and protocols from the operating theaters. The diagnosis was verified through medical records and/or radiographs. To compare with previous studies, the direct standardization method was used with the population of Oslo in 2019 as the standard. Results A total of 758 hip fractures, 70% women, were identified in 2019. The age-standardized incidence rates per 10,000 person-years in 2019 (95% CI) were 45 (41.1–48.8) for women and 30 (25.8–33.8) for men. In women, there has been a continuous decline in age-standardized rates the last three decades and in men the last two decades. The most pronounced decline was seen in the oldest age groups over 70 years. There has been a secular decline in both cervical and trochanteric fractures; however, the decrease in trochanteric fractures was most distinct for males, with more than two times higher risk in 1996/1997 compared to 2019. Conclusion Incidence rates for hip fractures in Oslo in 2019 were the lowest rate reported since 1978. The decrease was significant for both men and women. For the first time, the incidence rates are below the national rates of Norway. However, the rates are still among the highest worldwide. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-024-07156-8.

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Decrease in incidence of distal radius fractures in Oslo, Norway

Oftebro,

Skjaker,

Fridheim

et al. 2024

Arch Osteoporos

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Summary This study reported the incidence of validated adult distal radius fractures in Oslo, Norway, in 2019. The incidence has been reduced over the last 20 years. However, it is still high compared to other regions in Norway and some of the other Nordic countries. Purpose We aimed to report the incidence of distal radius fractures in Oslo in 2019 and compare it to the incidence rates in 1998/1999. Methods Patients aged ≥ 20 years resident in Oslo sustaining a distal radius fracture in 2019 were identified by electronic diagnosis registers, patient protocols, and/or radiology registers. The diagnosis was verified using medical records and/or radiology descriptions. We used the same method as the previous study from Oslo, making the comparison over time more accurate. The age-adjusted incidence rates and the age-standardized incidence rate ratio (IRR) were calculated. Results The absolute number of fractures decreased from 1490 in 1998/1999 to 1395 in 2019. The IRR for women and men in the age group ≥ 20 years in 2019 compared to 1998/1999 was 0.77 (95% CI 0.71–0.84) and 0.77 (95% CI 0.66–0.90), respectively. The IRR for women and men in the age group ≥ 50 years in 2019 compared to 1998/1999 was 0.78 (95% CI 0.71–0.86) and 0.78 (95% CI 0.63–0.97), respectively. For the population in Oslo with Asian background compared to Norwegian background in the age group ≥ 50 years, the IRR in 2019 was 0.57 (95% CI 0.40–0.80) for women and 0.77 (95% CI 0.44–1.37) for men. Conclusions The incidence of distal radius fractures in Oslo has decreased over the last 20 years. It is still, however, higher than in other areas of Norway and in some of the other Nordic countries.

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Explaining declining hip fracture rates in Norway: a population-based modelling study

Cited by 6 publications

References 32 publications

The impact of an ageing population on future increases in hip fracture burden

The impact of an ageing population on future increases in hip fracture burden

The hip fracture incidence in the high-risk area Oslo continues to decline

Decrease in incidence of distal radius fractures in Oslo, Norway

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