Journal
BONE
Volume 53, Issue 2, Pages 430-436Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bone.2012.12.014
Keywords
Bisphosphonates; Osteoporosis; Hip fractures; Anti-osteoporotic medication; Population studies
Categories
Funding
- FEDER funds through the Programa Operacional Factores de Competitividade COMPETE
- Portuguese funds through FCT Fundactio para a Ciencia e a Tecnologia [PEst-C/SAU/LA0002/2011]
- [PTDC/SAU-EPI/113424/2009]
- [SFRH/BD/40978/2007]
- Fundação para a Ciência e a Tecnologia [SFRH/BD/40978/2007] Funding Source: FCT
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The aim is to examine the temporal trends of hip fracture incidence in Portugal by sex and age groups, and explore the relation with anti-osteoporotic medication. From the National Hospital Discharge Database, we selected from 1st January 2000 to 31st December 2008, 77,083 hospital admissions (77.4% women) caused by osteoporotic hip fractures (low energy, patients over 49 years-age), with diagnosis codes 820.x of ICD 9-CM. The 2001 Portuguese population was used as standard to calculate direct age-standardized incidence rates (ASIR) (100,000 inhabitants). Generalized additive and linear models were used to evaluate and quantify temporal trends of age specific rates (AR), by sex. We identified 2003 as a turning point in the trend of ASIR of hip fractures in women. After 2003, the ASIR in women decreased on average by 10.3 cases/100,000 inhabitants, 95% Cl (-15.7 to -4.8), per 100,000 anti-osteoporotic medication packages sold. For women aged 65-69 and 75-79 we identified the same turning point. However, for women aged over 80, the year 2004 marked a change in the trend, from an increase to a decrease. Among the population aged 70-74 a linear decrease of incidence rate (95% Cl) was observed in both sexes, higher for women: -28.0% (-36.2 to -19.5) change vs -18.8%, (-32.6 to -2.3). The abrupt turning point in the trend of ASIR of hip fractures in women is compatible with an intervention, such as a medication. The trends were different according to gender and age group, but compatible with the pattern of bisphosphonates sales. (C) 2013 Elsevier Inc. All rights reserved.
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