德国 1995-2010 年髋部骨折发生率。

Incidence of hip fractures in Germany, 1995-2010.

机构信息

Department of Public Health, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstr. 59, 40225 Düsseldorf, Germany.

出版信息

Arch Osteoporos. 2013;8:140. doi: 10.1007/s11657-013-0140-5. Epub 2013 May 15.

DOI:10.1007/s11657-013-0140-5

PMID:23674147

Abstract

UNLABELLED

We analyzed hip fracture incidence trends in Germany in 1995-2010, using national hospital discharge register. Overall, after age-sex-region adjustment, there was no significant trend. However, stratified analyses showed a significant decrease in younger people. In the elderly, there was a moderate increase in men and decrease in women. Incidences were still higher in Western Germany (each significant).

BACKGROUND

Whereas most studies from US and European countries found trends of a decreasing hip fracture incidence in the last years, in Germany, an increase has been still observed up to 2003.

METHODS

Analysis of annual hip fracture incidences in Germany was carried out using the national hospital discharge register and a correction factor of 0.89. Estimate of age-sex-adjusted changes was determined using the Poisson regression (incidence rate ratios, IRR; with 95 % confidence intervals, CI), overall and in age-sex-region strata.

RESULTS

The number of patients with at least one hospital admission for hip fracture increased (1995: n = 99,146; 2010: n = 128,240). Overall, after adjustment for age, sex, and region, there was no significant trend during the observation period. However, in stratified analyses, a significant decrease was seen in people aged less than 40 years in both sexes and regions. Also, in women aged 60 years or older, the incidence decreased (Western Germany p = 0.001) or remained (Eastern Germany p = 0.053) (IRR 1995-2010, 95 % CI: 0.95, 0.92-0.98; and 1.05, 0.999-1.11). In contrast, the incidence in men 40-59 and 60 years older increased in both regions (West: 1.03, 0.97-1.09; and 1.11, 1.07-1.14; East: 1.12, 1.01-1.25; and 1.29, 1.22-1.36). While incidences were still significantly higher in Western Germany overall and in most strata, they tended to converge.

CONCLUSIONS

In line with most European countries, the overall hip fracture incidence in Germany no longer increases. However, differences between age, sex, and region exist.

摘要

目的

使用国家住院患者登记系统分析德国 1995-2010 年髋部骨折发病率趋势。方法：使用国家住院患者登记系统和 0.89 的校正系数对德国髋部骨折的年发病率进行分析。采用泊松回归（发病率比，IRR；95%置信区间，CI），对总体和年龄性别区域分层进行年龄性别调整变化的估计。结果：至少有一次因髋部骨折住院的患者人数增加（1995 年：n=99146；2010 年：n=128240）。总体而言，在观察期间，经年龄、性别和地区调整后，无显著趋势。然而，在分层分析中，两性和各地区年龄小于 40 岁的人群中，发病率显著下降。此外，在年龄 60 岁或以上的女性中，发病率下降（西德 p=0.001）或保持不变（东德 p=0.053）（1995-2010 年 IRR，95%CI：0.95，0.92-0.98；1.05，0.999-1.11）。相比之下，在两个地区，40-59 岁和 60 岁以上的男性发病率均上升（西德：1.03，0.97-1.09；1.11，1.07-1.14；东德：1.12，1.01-1.25；1.29，1.22-1.36）。尽管总体而言，西德的发病率仍明显高于其他地区，且各分层也存在差异，但两者之间的差异有缩小的趋势。结论：与大多数欧洲国家一样，德国髋部骨折的总体发病率不再上升。然而，年龄、性别和地区之间存在差异。