Rapp Kilian, Büchele Gisela, Dreinhöfer Karsten, Bücking Benjamin, Becker Clemens, Benzinger Petra
Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany.
Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081, Ulm, Germany.
Z Gerontol Geriatr. 2019 Feb;52(1):10-16. doi: 10.1007/s00391-018-1382-z. Epub 2018 Mar 28.
Hip fractures are regarded as a worldwide epidemic and a major public health concern. Changing risk factors, local differences and temporal trends contribute to the particular epidemiology of hip fractures. This overview gives a comprehensive insight into the epidemiology of hip fractures and reviews where German data have contributed to the literature.
The review of the epidemiology of hip fractures in Germany is based on a systematic literature search in PubMed. Information about the global epidemiology of hip fractures was provided by a selective literature review focusing on specific aspects of the epidemiology of hip fractures.
Hip fracture rates vary more than 100-fold between different countries. In most high-income countries, a rise in age-standardized hip fracture rates was observed until the 1980s and 1990s and a decrease thereafter. Such a decrease has not been observed for Germany so far. Many factors, diseases and drugs have been found to be associated with hip fractures and there is some evidence that fracture risk in later life is already programmed during fetal life and early childhood. Of the hip fracture burden 50% occur in people with disability and in need of care. In nursing homes approximately 4 fractures can be expected in 100 women per year. In people with intellectual or developmental disabilities comparable risks of hip fracture occur 10-40 years earlier than in the general population. Incidence of disability, institutionalization and death are frequent consequences of hip fractures.
The epidemiology of hip fractures is characterized by a high burden of disease, local differences, temporal trends, well-defined high-risk populations and many established risk factors.
髋部骨折被视为一种全球性的流行病，是一个重大的公共卫生问题。不断变化的风险因素、地区差异和时间趋势导致了髋部骨折独特的流行病学特征。本综述全面深入地探讨了髋部骨折的流行病学，并回顾了德国的数据对该领域文献的贡献。
对德国髋部骨折流行病学的综述基于在PubMed上进行的系统文献检索。关于全球髋部骨折流行病学的信息通过对髋部骨折流行病学特定方面的选择性文献综述提供。
不同国家之间的髋部骨折发生率相差100倍以上。在大多数高收入国家，年龄标准化的髋部骨折发生率在20世纪80年代和90年代之前呈上升趋势，此后呈下降趋势。到目前为止，德国尚未观察到这种下降。已发现许多因素、疾病和药物与髋部骨折有关，并且有一些证据表明，晚年的骨折风险在胎儿期和幼儿期就已编程。髋部骨折负担的50%发生在残疾且需要护理的人群中。在养老院，预计每年每100名女性中会发生约4例骨折。在智力或发育障碍人群中，髋部骨折的可比风险比普通人群早10 - 40年出现。残疾、入住机构和死亡的发生率是髋部骨折常见的后果。
髋部骨折的流行病学特征为疾病负担高、地区差异、时间趋势、明确的高危人群以及许多既定的风险因素。
