Incidence and Time Trend of Hip Fractures in Romania: a Nationwide Study From 2008 to 2018

Abstract

Background. Hip fractures are a major issue of public health as they are responsible for high morbidity, excess mortality and costs. There are differences in Europe and worldwide in the incidence rates of hip fractures and time trends, in the context of the population aging. Ten years ago, we characterized the incidence of hip fracture in Romania using data from the national hospital discharge register. Objective. This is the first Romanian study to assess the hip fracture incidence rates over a period of 11 years, between 2008 and 2018. Subjects and Methods. This analysis is a nationwide retrospective study on hospitals reporting primary DRG data on hip fracture, using a rigorous definition with both diagnostic and surgical procedure codes. The population aged 40+ was stratified in 5-year intervals and both the crude incidence rates and the adjusted incidence rates of hip fracture using standardization on age for the 2018 reference population were calculated in women and men. Results. From 2008 to 2018, the number of hip fractures rose by 53 % in women (from 7513 to 11512) and 22.4 % in men (from 4266 to 5220). Meanwhile, the Romanian population over 40 years increased by 12.5% in women and 14.2% in men. The crude incidence rate rose by 36.2% in women and 7.2% in men and the age-standardized incidence rates by 27.4% in women and 6% in men. These increases are mostly based on 85+ age populations' changes. Conclusions. In Romania, the hip fractures incidence continues to grow throughout an 11-year-period, especially in women, representing an increasing burden for our society.

Osteoporotic Hip Fracture Incidence Rates in the Main Urban Area of Romania

“…The incidences found in our study are higher than previously reported incidences in nationwide studies (6,8). A description of studies/reports regarding hip fracture incidence in Romania is found in Table 4.…”

“…The possibility of a more correct registration in the developed areas can be considered. In the most recent published study (8) NIPH=National Institute of Public Health. * although defined by the author as population-based studies, data presented represents hospital reported data based on ICD 10 codes with no available data from primary care sources or estimations of non-hospitalized hip fractures.…”

“…A more accurate approach for the calculation of incidence of hip fracture would imply a combined hospital and primary care data but currently this approach is unfeasible in Romania. No data from primary care registries or estimations of non-hospitalized fractures were included in the previous nationwide population (6,8). Choosing a highly urbanized area that associates a higher number of medical facilities is the optimal approach to minimize the non-hospitalized fractures.…”

“…Recently, a nationwide study calculated the incidence and time trends of hip fracture in Romania based on hospital reported DRG codes and included only surgically treated fractures (8).…”