Department of Rheumatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Department of Clinical Research, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Arch Osteoporos. 2019 Nov 27;14(1):115. doi: 10.1007/s11657-019-0665-3.
Our objective was to analyze the incidence and trend of hip fracture in Spain and its distribution by Autonomous Community (AC). In Spain, the age-adjusted incidence rate of hip fracture is decreasing. There is great variability in the incidence and tendency of hip fracture among the different ACs. Genetic, demographic, and climatic factors and cohort effect factors of the civil war explain 96% of this variability.
In Spain, there is great variability between the different Autonomous Communities (ACs) in the incidence of hip fracture. The objectives of our study are (1) to estimate the incidence rate and trend of hospital admissions for hip fracture in Spain and by ACs and (2) to analyze risk factors/markers that could explain the variability in the incidence and trend between different ACs.
This work includes 2 studies (TREND-HIP and VAR-HIP). TREND-HIP: retrospective, national, observational study based on the administrative database of the National Health System that includes a Minimum Basic Data Set (MBDS) of hospital admissions. VAR-HIP: ecological study based on the analysis of the results obtained in TREND-HIP study, with different risk factors/markers obtained from different sources.
In the 17 years included in the analysis, there were 744,848 patients diagnosed with hip fracture. The global age-adjusted rate of hip fracture at the national level was 315.38/100,000 person*year (95% CI 312.36-317.45); by AC, the rate varied from 213.97 in the Canary Islands to 363.13 in the Valencia and Cataluña communities. We observe an east-west gradient in Spain. The trend for both sexes was - 0.67% (95% CI 0.9990-0.9957) (p < 0.001). In the analysis of risk factors/markers that explain this distribution, we found significant correlations with genetic factors, demographics, climatic factors and the time a region was on the Republican side of the civil war. The linear regression model that includes the factors that show significant correlation explains 96% of the variability observed.
In Spain, the age-adjusted incidence rate for hip fracture is decreasing. There is a great variability in the incidence and tendency of hip fracture among the different ACs. Genetic, demographic, climatic factors and the cohort effect of the civil war explain 96% of this variability.
分析西班牙髋部骨折的发病率和趋势及其按自治区（Autonomous Community，AC）的分布情况。西班牙的年龄调整后髋部骨折发病率呈下降趋势。不同自治区之间髋部骨折的发病率和趋势存在很大差异。内战的遗传、人口、气候因素和队列效应因素可解释 96%的这种变异性。
在西班牙，不同自治区之间髋部骨折的发病率存在很大差异。本研究的目的是（1）估计西班牙及各自治区因髋部骨折住院的发病率和趋势；（2）分析可解释不同自治区发病率和趋势差异的风险因素/标志物。
本研究包含两项研究（TREND-HIP 和 VAR-HIP）。TREND-HIP：基于国家卫生系统的行政数据库的回顾性、全国性、观察性研究，其中包括最小基本数据集（Minimum Basic Data Set，MBDS）的住院记录。VAR-HIP：基于 TREND-HIP 研究结果的生态研究，使用了从不同来源获得的不同风险因素/标志物。
在纳入分析的 17 年中，共有 744848 例患者被诊断为髋部骨折。全国层面经年龄调整后的髋部骨折总发病率为 315.38/100000 人·年（95%可信区间为 312.36-317.45）；按自治区划分，发病率从加那利群岛的 213.97 到瓦伦西亚和加泰罗尼亚自治区的 363.13 不等。我们观察到西班牙存在一个从东到西的梯度。两性的趋势为-0.67%（95%可信区间为 0.9990-0.9957）（p<0.001）。在分析解释这种分布的风险因素/标志物时，我们发现与遗传因素、人口统计学因素、气候因素以及一个地区在共和派内战中处于哪一方的时间有显著相关性。包括显示显著相关性的因素的线性回归模型可解释 96%的观察到的变异性。
在西班牙，年龄调整后的髋部骨折发病率呈下降趋势。不同自治区之间髋部骨折的发病率和趋势存在很大差异。遗传、人口、气候因素以及内战的队列效应可解释 96%的这种变异性。
