Hospitalizations for major osteoporotic fractures in Switzerland: a long-term trend analysis between 1998 and 2018

Abstract

Between 1998 and2018, the number of hospitalizations for major osteoporotic fractures increased. After standardization for age, these numerical increases translated into a reduced incidence of hospitalizations for hip fractures and an increased incidence of hospitalizations for spine, proximal humerus, and distal radius fractures in both sexes. Introduction The longterm epidemiological trends of hospitalizations for major osteoporotic fractures (MOF) between 1998 and 2018 in Switzerland are unknown. Methods The absolute number of acute hospitalizations for MOF (hip fractures and fractures of the spine, proximal humerus, and distal radius) and related length of acute hospital stay were extracted from the medical database of the Swiss Federal Office of Statistics. Age-standardized incidence rates were calculated using 1998 as the reference year. Results Hospitalizations for MOF increased from 4483 to 7542 (+ 68.2%) in men and from 13,242 to 19,362 (+ 46.2%) in women. The age-standardized incidence of hospitalizations for MOF increased by 5.7% in men (p = 0.002) and by 5.1% in women (p = 0.018). The age-standardized incidence of hip fractures decreased by 15.3% in men (p < 0.001) and by 21.5% in women (p < 0.001). In parallel, the age-standardized incidence of MOF other than hip fractures increased by 31.8% in men (p < 0.001) and by 40.1% in women (p < 0.001). The mean length of acute hospital stays for MOF decreased from 16.3 to 8.5 days in men and from 16.9 to 8.1 days in women. Conclusion Between 1998 and 2018, the number of hospitalizations for MOF increased significantly by a larger extent than expected based on the ageing of the Swiss population alone. This increase was solely driven by an increased incidence of MOF other than hip fractures as incident hip fractures decreased over time in both sexes, more so in women than in men.

The osteoporosis treatment gap in Switzerland between 1998 and 2018

“…In Switzerland, the number of hospitalizations for hip fractures has continuously increased since 1998 in both men and women, mainly due to the rapid aging of the population [ 3 ]. The age-standardized and, to a lesser extent, the crude incidence of hospitalizations for hip fractures have been regularly decreasing since 1998 in both men and women [ 3 ]. The crude pooled incidence of hip fractures in men and women aged 45 years or older was 354 per 100,000 persons in 1998, 300 in 2008 (Fig.…”

“…The number of hospitalizations for hip fractures in men and women aged 45 years and older were extracted for the years 1998 through 2018 from the Swiss Federal Office of Statistics health database using the ICD-10 codes S72.0 Fracture of the femoral neck, S72.1 Pertrochanteric fracture, and S72.2 Subtrochanteric fracture) [ 3 ]. The crude incidence of hip fractures in men and women pooled was calculated per 100,000 person-years.…”

“…The crude incidence of hip fractures in men and women pooled was calculated per 100,000 person-years. In the absence of available covariates, the degree of association between the number of patients treated by year and the earlier reported decrease in hip fracture incidence [ 3 ] was explored by univariate regression analyses. It was considered that all hip fractures were hospitalized.…”

“…In Switzerland, approximately 1 in 2 women and 1 in 5 men will sustain a fragility fracture during their remaining lifetime after age 50 [ 2 ]. While increasing in number, the incidence and even more so the age-standardized incidence of hospitalizations for hip fractures have been shown to follow a long-lasting decreasing trend between 1998 and 2018 in both men and women [ 3 ]. During these 21 years of observation, the proportion of hospitalizations for hip fractures of all hospitalizations for MOF decreased from approximately 55% in both men and women to 44% and 42% in men and women, respectively.…”

The Possible Role of Electrical Stimulation in Osteoporosis: A Narrative Review

“…In a community survey of 5585 people with an average age of 77 years old in the UK, it was found that the incidence of osteoporosis was more than 50% [ 6 ]. In osteoporosis patients, spine fractures and hip fractures are common; they affect the quality of life of patients, threaten the health of elderly patients, and can cause fatal complications [ 7 , 8 , 9 ]. Osteoporosis treatments include bisphosphonates, selective estrogen receptor modulators, estrogens, and parathyroid hormones.…”