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Hip fractures in Norway 1999–2008: time trends in total incidence and second hip fracture rates. A NOREPOS study

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Abstract

Declining incidences of hip fractures are reported from western countries. Norway has among the highest rates in the world. The aim of this study was to investigate trends in total hip fracture rates in Norway between 1999 and 2008 and risk of second hip fractures. All hospitalizations given a hip fracture diagnosis code (International Classification of Diseases (ICD) 9 or ICD 10) (cervical, trochanteric or subtrochanteric) in Norwegian hospitals were retrieved with accompanying surgical procedure codes and additional diagnoses. A total of 93,123 hip fractures were identified between 1999 and 2008 in persons ≥50 years. Annual incidences of hip fractures were calculated and tested for trends. Rates of first and second hip fractures (2006–2008) were compared. The age-standardized total incidence of hip fracture decreased by 13.4 % (95 % confidence interval (CI): 11.0–15.6) in women and 4.8 % (95 % CI: 0.7, 8.7) in men. Age-adjusted rates of second hip fractures did not change in the observation period. In those with a prior hip fracture, the age-standardized risk of a subsequent hip fracture was 2.5-fold (95 % CI: 2.5, 2.6) in women, and 4.6-fold (95 % CI: 4.5, 4.7) in men. Total hip fracture rates declined in both genders during 1999–2008, whereas rates of second hip fractures did not change.

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Acknowledgments

The authors are deeply grateful to system architect monitoring Tomislav Dimoski at The Norwegian Knowledge Centre for the Health Services who developed the system that enabled extraction and transfer of data from PAS. He and his team also carried through the collection of the hip fracture data. Senior advisor Dominic Hoff at the Norwegian Institute of Public Health helped with data processing. The authors thank the staff at the Department of Pharmacoepidemiology (Norwegian Institute of Public Health), and Sverre Bjarte Johnsen (Statistics Norway) for assisting in transferring the data to the Norwegian Institute of Public Health and in the encryption process. Hip fracture data for validation of the NOREPOS Hip Fracture Database were obtained from local fracture registries in Tromsø and Oslo, and the authors thank the study investigators for their permission to use these data. This study was supported by a grant from the Research Council of Norway.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4704 Nydalen, 0403, Oslo, Norway

    Tone K. Omsland, Kristin Holvik, Haakon E. Meyer, Aage Tverdal & Anne Johanne Søgaard

  2. Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway

    Tone K. Omsland, Kristin Holvik, Nina Emaus & Grethe S. Tell

  3. Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway

    Haakon E. Meyer

  4. Osteoporosis and Bone Biology Program, Garvan Institute of Medical Research, Sydney, NSW, Australia

    Jacqueline R. Center & John A. Eisman

  5. Department of Health and Care Sciences, University of Tromsø, Tromsø, Norway

    Nina Emaus

  6. Department of Obstetrics and Gynecology, Faculty of Medicine, St. Olav’s University Hospital, Trondheim, Norway

    Berit Schei

  7. Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Berit Schei & Siri Forsmo

  8. Department of Rheumatology, Haukeland University Hospital, Bergen, Norway

    Clara G. Gjesdal

  9. Section of Rheumatology, Institute of Medicine, University of Bergen, Bergen, Norway

    Clara G. Gjesdal

  10. Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

    Guri Grimnes

  11. Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway

    Guri Grimnes

Authors
  1. Tone K. Omsland
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  2. Kristin Holvik
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  3. Haakon E. Meyer
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  4. Jacqueline R. Center
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  5. Nina Emaus
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  6. Grethe S. Tell
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  7. Berit Schei
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  8. Aage Tverdal
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  9. Clara G. Gjesdal
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  10. Guri Grimnes
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  11. Siri Forsmo
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  12. John A. Eisman
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  13. Anne Johanne Søgaard
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Corresponding author

Correspondence to Tone K. Omsland.

Additional information

NOREPOS (The NORwegian EPidemiologic Osteoporosis Studies) is a collaboration between epidemiologic osteoporosis studies, which are sub-studies within large population-based surveys in four districts of Norway (Tromsø, Nord-Trøndelag, Hordaland, Oslo). The NOREPOS Hip fracture Database includes all hospitalizations for hip fracture in Norway.

Electronic supplementary material

Below is the link to the electronic supplementary material.

10654_2012_9711_MOESM1_ESM.doc

Supplementary table Total number of hip fractures1999–2008 in five year age groups in women and men. The NOREPOS Hip Fracture Database 1999–2008 (DOC 35 kb)

Supplementary material 2 (PDF 213 kb)

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Omsland, T.K., Holvik, K., Meyer, H.E. et al. Hip fractures in Norway 1999–2008: time trends in total incidence and second hip fracture rates. A NOREPOS study. Eur J Epidemiol 27, 807–814 (2012). https://doi.org/10.1007/s10654-012-9711-9

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  • DOI: https://doi.org/10.1007/s10654-012-9711-9

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