Department of Osteoporosis, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Swiss Federal Statistical Office, Neuchâtel, Switzerland.
Osteoporos Int. 2024 May;35(5):893-902. doi: 10.1007/s00198-024-07016-5. Epub 2024 Feb 24.
Number and age-standardized incidences of femoral fractures by sex and localization were determined annually between 1998 and 2021 in subjects aged 45 years or older living in Switzerland. The number and incidences of femoral neck, pertrochanteric, subtrochanteric, and femoral shaft fractures followed distinct unexpected trend patterns.
Long-term incidence trends for femoral fractures by individual localizations are unknown.
Annual absolute number of hospitalizations and median age at hospital admission between 1998 and 2021 were extracted from the medical database of the Swiss Federal Office of Statistics by sex and 10-year age groups for the following 10th International Classification of Diseases (ICD-10) codes: femoral neck (ICD-10 S72.0), pertrochanteric (S72.1), subtrochanteric (S72.2), and femoral shaft fractures (S72.3). Age-standardized incidence rates (ASI) and corresponding trends were calculated.
Over 24 years, the number of femoral neck fractures increased in men (+ 45%) but decreased in women (- 7%) with ASI significantly decreasing by 20% and 37% (p < 0.001 for trend for both), respectively. By contrast, the number of pertrochanteric fractures increased by 67% and 45% in men and women, respectively, corresponding to a horizontal ASI-trend in men (n.s.) and a modest significant decreasing ASI-trend in women (p < 0.001). The number of subtrochanteric fractures increased in both sexes with corresponding modest significant reductions in ASI-trends (p = 0.015 and 0.002, respectively). Femoral shaft fractures almost doubled in men (+ 71%) and doubled in women (+ 100%) with corresponding significant increases in ASI-trends (p = 0.001 and p < 0.001, respectively). Age at admission increased for all fracture localizations, more so in men than in women and more so for subtrochanteric and shaft fractures than for "typical" hip fractures.
Incidence changes of pertrochanteric fractures and femoral shaft fractures deserve increased attention, especially in men. Pooling diagnostic codes for defining hip fractures may hide differing patterns by localization and sex.
目的： 我们旨在研究瑞士各年龄段人群中不同部位股骨骨折的发病率变化趋势。
方法： 我们从瑞士联邦统计局的医疗数据库中提取了 1998 年至 2021 年期间，按性别和 10 岁年龄组划分的以下 10 个国际疾病分类（ICD-10）编码的住院人数和中位年龄：股骨颈（ICD-10 S72.0）、股骨粗隆间（S72.1）、股骨粗隆下（S72.2）和股骨干骨折（S72.3）。计算了年龄标准化发病率（ASI）和相应的趋势。
结果： 24 年来，男性股骨颈骨折人数增加（+45%），女性减少（-7%），相应的 ASI 分别显著下降 20%和 37%（趋势 p 值均<0.001）。相比之下，男性和女性的股骨粗隆间骨折人数分别增加了 67%和 45%，男性的 ASI 趋势呈水平状（无统计学意义），女性的 ASI 趋势略有显著下降（p<0.001）。男女的股骨粗隆下骨折人数均增加，相应的 ASI 趋势呈适度显著下降（p=0.015 和 0.002）。男性股骨骨干骨折人数几乎翻了一番（+71%），女性增加了一倍（+100%），相应的 ASI 趋势显著增加（p=0.001 和 p<0.001）。所有骨折部位的入院年龄均增加，男性增加得更多，女性增加得更多，股骨粗隆下和骨干骨折的增加比“典型”髋部骨折更为明显。
结论： 股骨粗隆间骨折和股骨干骨折的发病率变化值得关注，尤其是在男性中。将诊断代码汇总起来定义髋部骨折可能会掩盖不同部位和性别的不同模式。
