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HIP FRACTURE INCIDENCE IN NEW ZEALAND, REVISITED



Abstract

Introduction: Hip fractures in the elderly create an economic and social burden on individuals and society. Earlier predictions of the incidence of hip fractures in the older adult population showed that by the year 2011 the rate would rise to epidemic proportions.

Aim: To analyse the actual hip fracture rate from 1988 to 1999 and then to compare it with the hip fracture rate predicted by Rockwood, Horne and Cryer in 1990.

Method: Data on the number of patients admitted to New Zealand hospitals with a diagnosis of fractured neck of femur were obtained, and compared with Rockwood’s (1990) weighted regression and baseline predictions. Poisson regression was used to test for changes in hip fracture rates over time.

Results: The numbers of hip fractures for females, from 1988 to 1993, were similar to the numbers predicted, yet have been significantly lower than stated predictions since 1995 (all age bands, P < 0.002; in the 85+ group, p < 0.0001). For males, hip fracture numbers are closer to those predicted, and since 1995 are less than the weighted regressions predicted. The difference was not statistically significant.

Conclusions: Despite the absence of a nationally agreed and coordinated strategy aimed at osteoporosis prevention, it appears that the use of risk assessments, osteoporosis prevention strategies, in combination with improved retirement home and personal care interventions and treatments are likely to have contributed to this situation. The 4.6% drop in the age group most at risk of hip fracture (85+), may be a contributing factor.

The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.

Reference:

Rockwood PR, Horne JG, Cryer C. Hip fractures: a future epidemic? Journal of Orthopaedic Trauma1990; 4(4): 388–393. Google Scholar