Hip fracture incidence rates in Singapore 1991-1998

In this population-based study, we determined the incidence rates of hip fr acture among Singapore residents aged 50 years and above. Information was o btained from a centralized database system which captured admissions with t he primary diagnosis of a closed hip fracture (ICD-9 codes 820, 820.0, 820. 2 and 820.8, n = 12 927) from all health care establishments in the country from 1991 to 1998 inclusive. After removing duplicates, hospital transfers , readmissions and nonacute care admissions, the total number of hip fractu res was 9406. Based on the national population census 1990 (n = 464 100) an d yearly population estimates, the age-adjusted hip fracture rates for 1991 -1998 (per 100 000) were 152 in men and 402 in women. This was 1.5 and over 5 times higher than corresponding rates in the 1960s. From 1991 to 1998, t hese hip fracture rates tended to increase by 0.7% annually in men and by 1 .2% annually in women. Among the three major racial groups, in men, the Chi nese had significantly higher age adjusted hip fracture rates (per 100 000) : 168 (95% confidence interval (CI) 158-178) compared with 128 (95% CI 105- 152) for Indians and 71 (95% CI 54-88) for Malays. A similar pattern occurr ed in women: 410 (95% CI 395-425), for Chinese compared with 361 (95% CI 29 0-432) for Indians and 264 (95% CI 225-303) for Malays. Since the 1960s, th e main increases in hip fracture rates have been seen in the Chinese and Ma lays, with the rates in Indians appearing to decrease. Hip fracture inciden ce rates in Singapore have risen rapidly over the past 30-40 years, particu larly in women, and are now among the highest in Asia. Significant racial d ifferences in hip fracture rates occur within the same community. Time tren ds in hip fracture rates differed between races.