Elsevier

Bone

Volume 29, Issue 5, November 2001, Pages 413-418
Bone

Epidemiology of hip fractures in Oslo, Norway

https://doi.org/10.1016/S8756-3282(01)00603-2Get rights and content

Abstract

The incidence of hip fractures in Oslo has shown a secular increase during the past decades. The main aims of the present study were to report the current incidence of hip fractures in Oslo and to determine whether there is a seasonal variation in the occurrence of fractures. Using the electronic diagnosis registers and the lists of the operating theater for the hospitals in Oslo with somatic care, all patients with ICD-9 code 820.X (hip fracture) from May 1, 1996 to April 30, 1997 were identified. Medical records for all identified patients were obtained and diagnosis was verified. Using the population of Oslo on January 1, 1997 as the population at risk, the age- and gender-specific annual incidence rates were calculated. These rates were compared with those for 1988/89 and 1978/79. Outdoor temparature data for Oslo were obtained to study the relation between temperature and number of hip fractures. A total number of 1316 hip fractures was included, of which 78% occurred in women. An exponential increase in incidence with age was observed in both genders. The age-adjusted fracture rates per 10,000 for the age group ≥50 years were 118.0 and 44.0 in 1996/97, 124.3 and 44.9 in 1988/89, and 104.5 and 35.8 in 1978/79 for women and men, respectively. There was no significant seasonal variation in the incidence of hip fractures and no correlation between mean outdoor temperature and number of fractures for each month in 1996/97. The data show that the incidence of hip fractures in Oslo has not changed significantly during the last decade, and it is still the highest reported. The cold climate of Oslo does not seem to contribute to the high incidence.

Introduction

Hip fracture represents an important cause of morbidity, mortality, and health care costs in the elderly.4, 5, 16, 20, 24 The incidence of hip fractures in Oslo has shown a secular increase during the past decades.8, 9 In 1988/89, the incidence per 10,000 for the age group ≥50 years was 118.7 in women and 45.4 in men.9 These incidence rates exceeded all those ever reported in Norway and elsewhere. However, recent studies from Malmö32 and Uppsala30 in Sweden and central Finland13 have shown that the incidence of hip fractures is no longer increasing, indicating a trend break.

In general, the incidence of hip fractures is very high in the Scandinavian countries.3, 5, 7, 9, 32 This suggests that the cold climate of these countries may contribute to the high incidence.19, 32 However, several reports have questioned this hypothesis.15, 22 The aim of the present study was to report the current incidence of hip fractures in Oslo to elucidate whether there has been a further increase during the last decade, and to compare this incidence with recent data from other countries. In addition, the seasonal variation in the occurrence of hip fractures and the relation between outdoor temperature and number of hip fractures were studied.

Section snippets

Materials and methods

In Oslo, there are four somatic hospitals to which a patient sustaining a hip fracture is referred for treatment. Three of these hospitals provide emergency service. Using the electronic diagnosis registers of the four hospitals, all patients with the International Classification of Diseases, ninth revision (ICD-9) code 820.X (hip fracture) from May 1, 1996 through April 30, 1997 were identified. In addition, the lists of the operating theater of the three hospitals with emergency service were

Results

A total number of 1335 hip fractures was identified. For nine patients the medical records were not available and the diagnosis was verified by review of X-ray and corresponding reports. Eight patients with cancer metastases at the fracture site and 11 patients not residing in the city of Oslo were excluded. The number of hip fractures included was thus 1316. These fractures occurred in 1291 patients as 25 women sustained two fractures within the inclusion period. Only ten patients were

Discussion

The present study shows that the incidence of hip fractures in Oslo has not changed significantly during the last decade, and it is still among the highest in the world. Furthermore, no significant seasonal variation in the distribution of hip fractures and no correlation between mean outdoor temperature and number of fractures for each month was found for 1996/97, whereas both a seasonal variation and a correlation between temperature and number of fractures were demonstrated for 1978/79.

Acknowledgements

The authors thank the four somatic hospitals of Oslo for help and assistance during the data collection. This study was supported financially by an unrestricted grant from Eli Lilly, Norway.

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