THE EPIDEMIOLOGY OF HIP FRACTURE IN ASTUR IAS, SPAIN

BACKGROUND: HIP fracture is the complication with the greatest medical repercussions in osteoporosis. The aim of this study was to know both the incidence of osteoporotic hip fracture in Asturias, Spain and the immediate evolution of these patients. METHODS: The clinical historie s of all the patients admitted for hip fracture in 1992 in two Asturia n public health care areas were reviewed. Hip fractures in patients un der the age of 45 years or those occurring because of other diseases ( metastasis, serious injury) were excluded. RESULTS: In the health care areas studied in 1992 there were 283 osteoporotic hip fractures with an incidence of 219.6 fractures/10(5) inhabitants/year in those over t he age of 50 years. The incidence in women over 45 years of age was 3- fold greater than that in men of the same age. The mean age of the pat ients was 80.2 +/- 8.9 years. The incidence in people over the age of 50 was greater in urban (266/10(5) inhab./year) than in the rural area s (185.7/10(5) inhab./year) (p < 0.001). Ten percent of the patients w ere residing in old age residences or hospitals at the time of the fra cture. Eighty-one percent required surgery. Home was the site of the f racture in 84% of the cases with no seasonal variation being observed. The most frequent intrahospitalary complications observed were infect ions (15%), cardiac or respiratory disturbances (18%), and confusion ( 8%). The mean hospital stay was 26.5 days with acute hospitalary morta lity of 5.6%. Nineteen point seven percent of the patients were transf erred to a center for chronically ill people. The total cost of the ho spital care for the hip fractures in this study exceeded 311 million p esetas in 1982. CONCLUSIONS: The epidemiology of osteoporotic hip frac ture in Asturias, Spain, follows a similar pattern as that found in ot her Spanish regions. It was found to be more frequent in the urban tha n in the rural areas. Hospitalary mortality of these patients is partl y determined by age and the number of complications which developed du ring hospital stay. The impact on the patients with osteoporotic hip f racture and on the economic resources destined to their attention just ifies the development of osteoporosis and fracture prevention programs .