Rua do Campo Alegre, 823, 4150-180 Porto, INEB, Instituto de Engenharia Biomédica, Portugal.
Bone. 2013 Apr;53(2):430-6. doi: 10.1016/j.bone.2012.12.014. Epub 2012 Dec 27.
The aim is to examine the temporal trends of hip fracture incidence in Portugal by sex and age groups, and explore the relation with anti-osteoporotic medication. From the National Hospital Discharge Database, we selected from 1st January 2000 to 31st December 2008, 77,083 hospital admissions (77.4% women) caused by osteoporotic hip fractures (low energy, patients over 49years-age), with diagnosis codes 820.x of ICD 9-CM. The 2001 Portuguese population was used as standard to calculate direct age-standardized incidence rates (ASIR) (100,000 inhabitants). Generalized additive and linear models were used to evaluate and quantify temporal trends of age specific rates (AR), by sex. We identified 2003 as a turning point in the trend of ASIR of hip fractures in women. After 2003, the ASIR in women decreased on average by 10.3 cases/100,000 inhabitants, 95% CI (-15.7 to -4.8), per 100,000 anti-osteoporotic medication packages sold. For women aged 65-69 and 75-79 we identified the same turning point. However, for women aged over 80, the year 2004 marked a change in the trend, from an increase to a decrease. Among the population aged 70-74 a linear decrease of incidence rate (95% CI) was observed in both sexes, higher for women: -28.0% (-36.2 to -19.5) change vs -18.8%, (-32.6 to -2.3). The abrupt turning point in the trend of ASIR of hip fractures in women is compatible with an intervention, such as a medication. The trends were different according to gender and age group, but compatible with the pattern of bisphosphonates sales.
通过性别和年龄组检查葡萄牙髋部骨折发病率的时间趋势，并探讨与抗骨质疏松药物的关系。我们从国家住院数据库中选择了 2000 年 1 月 1 日至 2008 年 12 月 31 日期间，77083 例（77.4%为女性）因骨质疏松性髋部骨折（低能量，年龄在 49 岁以上）住院，其诊断代码为 ICD-9-CM 的 820.x。以 2001 年葡萄牙人口为标准，计算直接年龄标准化发病率（ASIR）（每 10 万人）。采用广义加性和线性模型，按性别评估和量化特定年龄组（AR）的时间趋势。我们发现 2003 年是女性髋部骨折 ASIR 趋势的转折点。2003 年后，女性 ASIR 平均每年下降 10.3 例/每 10 万人，95%CI（-15.7 至-4.8），每销售 10 万份抗骨质疏松药物包。对于 65-69 岁和 75-79 岁的女性，我们发现了相同的转折点。然而，对于 80 岁以上的女性，2004 年标志着趋势的变化，从上升转为下降。在 70-74 岁的人群中，两性的发病率（95%CI）呈线性下降，女性下降幅度更大：-28.0%（-36.2 至-19.5），而男性为-18.8%（-32.6 至-2.3）。女性髋部骨折 ASIR 趋势的突然转折点与药物等干预措施相符。趋势因性别和年龄组而异，但与双膦酸盐销售模式相符。
