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Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the national health insurance claims data.

Kang HY, Yang KH, Kim YN, Moon SH, Choi WJ, Kang DR, Park SE - BMC Public Health (2010)

Bottom Line: Also, we examined factors associated with post-fracture mortality among Korean elderly to evaluate the impact of osteoporosis on our society and to identify high-risk populations.The 1-year mortality was 16.55%, which is 2.85 times higher than the mortality rate for the general population (5.8%) in this age group.The risk of post-fracture mortality at one year is significantly higher for males and for persons having lower socioeconomic status, living in places other than the capital city, not taking anti-osteoporosis pharmacologic therapy following fracture, or receiving fracture-associated operations from more advanced hospitals such as general or tertiary hospitals.

View Article: PubMed Central - HTML - PubMed

Affiliation: Graduate School of Public Health, Institute of Health Services Research, Yonsei University, Seoul, South Korea. hykang@yuhs.ac

ABSTRACT

Background: The lack of epidemiologic information on osteoporotic hip fractures hampers the development of preventive or curative measures against osteoporosis in South Korea. We conducted a population-based study to estimate the annual incidence of hip fractures. Also, we examined factors associated with post-fracture mortality among Korean elderly to evaluate the impact of osteoporosis on our society and to identify high-risk populations.

Methods: The Korean National Health Insurance (NHI) claims database was used to identify the incidence of hip fractures, defined as patients having a claim record with a diagnosis of hip fracture and a hip fracture-related operation during 2003. The 6-month period prior to 2003 was set as a 'window period,' such that patients were defined as incident cases only if their first record of fracture was observed after the window period. Cox's proportional hazards model was used to investigate the relationship between survival time and baseline patient and provider characteristics available from the NHI data.

Results: The age-standardized annual incidence rate of hip fractures requiring operation over 50 years of age was 146.38 per 100,000 women and 61.72 per 100,000 men, yielding a female to male ratio of 2.37. The 1-year mortality was 16.55%, which is 2.85 times higher than the mortality rate for the general population (5.8%) in this age group. The risk of post-fracture mortality at one year is significantly higher for males and for persons having lower socioeconomic status, living in places other than the capital city, not taking anti-osteoporosis pharmacologic therapy following fracture, or receiving fracture-associated operations from more advanced hospitals such as general or tertiary hospitals.

Conclusion: This national epidemiological study will help raise awareness of osteoporotic hip fractures among the elderly population and hopefully motivate public health policy makers to develop effective national prevention strategies against osteoporosis to prevent hip fractures.

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Related in: MedlinePlus

Comparison of age-specific incidence rates of hip fracture according to gender.
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Figure 1: Comparison of age-specific incidence rates of hip fracture according to gender.

Mentions: The incidence rate of hip fractures increased with increasing age, from 6.74 per 100,000 for the youngest group of 50-54 year olds to 686.82 per 100,000 for the oldest group of 85 years and older. This increase followed an exponential relationship after age 65 for both genders (Figure 1). About 34.0% of all hip fractures occurred in patients aged 80 years and older, although this age group comprised only 5.6% of the total population over 50.


Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the national health insurance claims data.

Kang HY, Yang KH, Kim YN, Moon SH, Choi WJ, Kang DR, Park SE - BMC Public Health (2010)

Comparison of age-specific incidence rates of hip fracture according to gender.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2874780&req=5

Figure 1: Comparison of age-specific incidence rates of hip fracture according to gender.
Mentions: The incidence rate of hip fractures increased with increasing age, from 6.74 per 100,000 for the youngest group of 50-54 year olds to 686.82 per 100,000 for the oldest group of 85 years and older. This increase followed an exponential relationship after age 65 for both genders (Figure 1). About 34.0% of all hip fractures occurred in patients aged 80 years and older, although this age group comprised only 5.6% of the total population over 50.

Bottom Line: Also, we examined factors associated with post-fracture mortality among Korean elderly to evaluate the impact of osteoporosis on our society and to identify high-risk populations.The 1-year mortality was 16.55%, which is 2.85 times higher than the mortality rate for the general population (5.8%) in this age group.The risk of post-fracture mortality at one year is significantly higher for males and for persons having lower socioeconomic status, living in places other than the capital city, not taking anti-osteoporosis pharmacologic therapy following fracture, or receiving fracture-associated operations from more advanced hospitals such as general or tertiary hospitals.

View Article: PubMed Central - HTML - PubMed

Affiliation: Graduate School of Public Health, Institute of Health Services Research, Yonsei University, Seoul, South Korea. hykang@yuhs.ac

ABSTRACT

Background: The lack of epidemiologic information on osteoporotic hip fractures hampers the development of preventive or curative measures against osteoporosis in South Korea. We conducted a population-based study to estimate the annual incidence of hip fractures. Also, we examined factors associated with post-fracture mortality among Korean elderly to evaluate the impact of osteoporosis on our society and to identify high-risk populations.

Methods: The Korean National Health Insurance (NHI) claims database was used to identify the incidence of hip fractures, defined as patients having a claim record with a diagnosis of hip fracture and a hip fracture-related operation during 2003. The 6-month period prior to 2003 was set as a 'window period,' such that patients were defined as incident cases only if their first record of fracture was observed after the window period. Cox's proportional hazards model was used to investigate the relationship between survival time and baseline patient and provider characteristics available from the NHI data.

Results: The age-standardized annual incidence rate of hip fractures requiring operation over 50 years of age was 146.38 per 100,000 women and 61.72 per 100,000 men, yielding a female to male ratio of 2.37. The 1-year mortality was 16.55%, which is 2.85 times higher than the mortality rate for the general population (5.8%) in this age group. The risk of post-fracture mortality at one year is significantly higher for males and for persons having lower socioeconomic status, living in places other than the capital city, not taking anti-osteoporosis pharmacologic therapy following fracture, or receiving fracture-associated operations from more advanced hospitals such as general or tertiary hospitals.

Conclusion: This national epidemiological study will help raise awareness of osteoporotic hip fractures among the elderly population and hopefully motivate public health policy makers to develop effective national prevention strategies against osteoporosis to prevent hip fractures.

Show MeSH
Related in: MedlinePlus