Secular trends in hip fracture occurrence and survival: age and sex differences.

The National Hospital Discharge Survey was used to analyze secular trends from 1965 to 1993 in hip fracture incidence and in-hospital survival in the White U.S. population 50 years of age and older. Age-specific fracture rates increased significantly for males in age groups 80-84 years and 85 years and older but not for younger males. For females, age-specific rates did not change significantly over the time period. Age-specific survival rates increased for both older males and females, but the increase was greatest for the older men. Why hip fracture incidence is increasing in older males but not in females and younger males is not clear. But the high lifetime prevalence of smoking in the older cohort of males may be a factor. With rising incidence rates in elderly males, prevention efforts, which have focused primarily on women because of their high fracture rates, should target both sexes.