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Epidemiology of Pelvic Fractures in Germany: Considerably High Incidence Rates among Older People.

Andrich S, Haastert B, Neuhaus E, Neidert K, Arend W, Ohmann C, Grebe J, Vogt A, Jungbluth P, Rösler G, Windolf J, Icks A - PLoS ONE (2015)

Bottom Line: Our adjusted regression analysis confirmed a significant sex (RR 2.38 [2.23-2.55], p < 0.001, men as reference) and age effect (higher risk with increasing age, p < 0.001) on first fracture risk.We found a slight association between calendar year (higher risk in later years compared to 2008, p = 0.0162) and first fracture risk and a further significant association with region (RR 0.92 [0.87-0.98], p = 0.006, Westfalen-Lippe as reference).Prevention of low energy trauma among older people remains an important issue.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Faculty of Medicine, Heinrich-Heine University, Düsseldorf, Germany.

ABSTRACT
Epidemiological data about pelvic fractures are limited. Until today, most studies only analyzed inpatient data. The purpose of this study was to estimate incidence rates of pelvic fractures in the German population aged 60 years or older, based on outpatient and inpatient data. We conducted a retrospective population-based observational study based on routine data from a large health insurance company in Germany. Age and sex-specific incidence rates of first fractures between 2008 and 2011 were calculated. We also standardized incidence rates with respect to age and sex in the German population. Multiple Poisson regression models were used to evaluate the association between the risk of first pelvic fracture as outcome and sex, age, calendar year and region as independent variables. The total number of patients with a first pelvic fracture corresponded to 8,041 and during the study period 5,978 insured persons needed inpatient treatment. Overall, the standardized incidence rate of all first pelvic fractures was 22.4 [95% CI 22.0-22.9] per 10,000 person-years, and the standardized incidence rate of inpatient treated fractures 16.5 [16.1-16.9]. Our adjusted regression analysis confirmed a significant sex (RR 2.38 [2.23-2.55], p < 0.001, men as reference) and age effect (higher risk with increasing age, p < 0.001) on first fracture risk. We found a slight association between calendar year (higher risk in later years compared to 2008, p = 0.0162) and first fracture risk and a further significant association with region (RR 0.92 [0.87-0.98], p = 0.006, Westfalen-Lippe as reference). The observed incidences are considerably higher than incidences described in the international literature, even if only inpatient treated pelvic fractures are regarded. Besides which, non-inclusion of outpatient data means that a relevant proportion of pelvic fractures are not taken into account. Prevention of low energy trauma among older people remains an important issue.

No MeSH data available.


Related in: MedlinePlus

Selection process of the study population.
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pone.0139078.g001: Selection process of the study population.

Mentions: We calculated person-years for the individual observation periods. Person-years were summed up for all insured persons aged minimum 60 years being at risk of having a first pelvic fracture, as predefined. According to the definition, all person-years in the first year of observation were excluded. Furthermore, person-years after first pelvic fracture events were deleted. The selection process of the study population (individuals with pelvic fractures and person years) is illustrated as a flow chart in Fig 1. For the entire study population aggregated persons-times, also stratified by year, sex, age and region are provided in Table 1.


Epidemiology of Pelvic Fractures in Germany: Considerably High Incidence Rates among Older People.

Andrich S, Haastert B, Neuhaus E, Neidert K, Arend W, Ohmann C, Grebe J, Vogt A, Jungbluth P, Rösler G, Windolf J, Icks A - PLoS ONE (2015)

Selection process of the study population.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4587805&req=5

pone.0139078.g001: Selection process of the study population.
Mentions: We calculated person-years for the individual observation periods. Person-years were summed up for all insured persons aged minimum 60 years being at risk of having a first pelvic fracture, as predefined. According to the definition, all person-years in the first year of observation were excluded. Furthermore, person-years after first pelvic fracture events were deleted. The selection process of the study population (individuals with pelvic fractures and person years) is illustrated as a flow chart in Fig 1. For the entire study population aggregated persons-times, also stratified by year, sex, age and region are provided in Table 1.

Bottom Line: Our adjusted regression analysis confirmed a significant sex (RR 2.38 [2.23-2.55], p < 0.001, men as reference) and age effect (higher risk with increasing age, p < 0.001) on first fracture risk.We found a slight association between calendar year (higher risk in later years compared to 2008, p = 0.0162) and first fracture risk and a further significant association with region (RR 0.92 [0.87-0.98], p = 0.006, Westfalen-Lippe as reference).Prevention of low energy trauma among older people remains an important issue.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Faculty of Medicine, Heinrich-Heine University, Düsseldorf, Germany.

ABSTRACT
Epidemiological data about pelvic fractures are limited. Until today, most studies only analyzed inpatient data. The purpose of this study was to estimate incidence rates of pelvic fractures in the German population aged 60 years or older, based on outpatient and inpatient data. We conducted a retrospective population-based observational study based on routine data from a large health insurance company in Germany. Age and sex-specific incidence rates of first fractures between 2008 and 2011 were calculated. We also standardized incidence rates with respect to age and sex in the German population. Multiple Poisson regression models were used to evaluate the association between the risk of first pelvic fracture as outcome and sex, age, calendar year and region as independent variables. The total number of patients with a first pelvic fracture corresponded to 8,041 and during the study period 5,978 insured persons needed inpatient treatment. Overall, the standardized incidence rate of all first pelvic fractures was 22.4 [95% CI 22.0-22.9] per 10,000 person-years, and the standardized incidence rate of inpatient treated fractures 16.5 [16.1-16.9]. Our adjusted regression analysis confirmed a significant sex (RR 2.38 [2.23-2.55], p < 0.001, men as reference) and age effect (higher risk with increasing age, p < 0.001) on first fracture risk. We found a slight association between calendar year (higher risk in later years compared to 2008, p = 0.0162) and first fracture risk and a further significant association with region (RR 0.92 [0.87-0.98], p = 0.006, Westfalen-Lippe as reference). The observed incidences are considerably higher than incidences described in the international literature, even if only inpatient treated pelvic fractures are regarded. Besides which, non-inclusion of outpatient data means that a relevant proportion of pelvic fractures are not taken into account. Prevention of low energy trauma among older people remains an important issue.

No MeSH data available.


Related in: MedlinePlus