Fractures associated with severe trauma are generally excluded from estimates of the prevalence of osteoporotic fractures in the community. Because the degree of trauma is difficult to quantitate, low bone mass may contribute to fractures following severe trauma. We ascertained all fractures in a defined population and compared the bone mineral density (BMD) of women who sustained fractures in either "low" or "high" trauma events with the BMD of a random sample of women from the same population. BMD was measured by dual-energy X-ray absorptiometry and expressed as a standardized deviation (Z score) adjusted for age. The BMD Z scores (mean ؎ SEM) were reduced in both the low and high trauma groups, respectively: spine
Objective
To calculate the expected increase in the number of fractures in adults attributable to the predicted increase in the number of elderly Australians.
Data sources
All fractures in adult residents (> 35 years) of the Barwon Statistical Division (total population, 218000) were identified from radiological reports from February 1994 to February 1996. The Australian Bureau of Statistics supplied predictions of Australia's population (1996 to 2051).
Main outcome measure
The projected annual number of fractures in Australian adults up to 2051 (based on stable rates of fracture in each age group).
Results
The number of fractures per year is projected to increase 25% from 1996 to 2006 (from 83000 fractures to 104000). Hip fractures are projected to increase 36% (from 15000 to 21000) because of a substantial rise in the number of elderly aged 85 years and over. Hip fractures are expected to double by 2026 and increase fourfold by 2051.
Conclusions
In contrast to Europe and North America, where numbers of hip fractures are expected to double by 2026 and then stabilise, in Australia hip fractures will continue to place a growing demand on healthcare resources for many decades. These projections can be used for setting goals and evaluating the costs and benefits of interventions in Australia.
The QoR-40 score is a useful instrument with which to assess quality of recovery in cranial and spinal surgery patients. Postoperative pain and neurologic deficits correlate with poor quality of recovery in these patients.
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