CURRENT AND PROJECTED RATES OF HIP FRACTURE IN CANADA

Objective: To determine the current values and estimate the projected values (to the year 2041) for annual number of proximal femoral fractu res (PFFs), age-adjusted rates of fracture, rates of death in the acut e care setting, associated length of stay (LOS) in hospital, and seaso nal variation by sex and age in elderly Canadians. Design: Hospital di scharge data for fiscal year 1993-94 from the Canadian Institute for H ealth Information were used to determine PFF incidence, and Statistics Canada population projections were used to estimate the rate and numb er of PFFs to 2041. Setting: Canada. Participants: Canadian patients 6 5 years of age or older who underwent hip arthroplasty. Outcome measur es: PFF rates, death rates and LOS by age, sex and province. Results: In 1993-94 the incidence of PFF increased exponentially with increasin g age. The age-adjusted rates were 479 per 100 000 for women and 187 p er 100 000 for men. The number of PFFs was estimated at 23 375 (17 823 in women and 5552 in men), with a projected increase to 88 124 in 204 1. The rate of death during the acute care stay increased exponentiall y with increasing age. The death rates for men were twice those for wo men. In 1993-94 an estimated 1570 deaths occurred in the acute care se tting, and 7000 deaths were projected for 2041. LOS in the acute care setting increased with advancing age, as did variability in LOS, which suggests a more heterogeneous case mix with advancing age. The LOS fo r 1993-94 and 2041 was estimated at 465 000 and 1.8 million patient-da ys respectively. Seasonal variability in the incidence of PFFs by sex was not significant. Significant season-province interactions were see n (p < 0.05); however, the differences in incidence were small (on the order of 2% to 3%) and were not considered to have a large effect on resource use in the acute care setting. Conclusions: On the assumption that current conditions contributing to hip fractures will remain con stant, the number of PFFs will rise exponentially over the next 40 yea rs. The results of this study highlight the serious implications for C anadians if incidence rates are not reduced by some form of interventi on.