Hip Fracture After Stroke in the Elderly: Trends in the Beginning of the 21st Century and Projections into the Future in Australia

Abstract

AIMS:To estimate age-and sex-specific incidence rates and time trends of post-stroke hip fracture (HF) in the Australian Capital Territory (ACT) and to present projections of future post-stroke HF incidence in Australia until 2051. METHODS: Analysis of annual age-and sex-specific standardized (to 2006 Australian population) post-stroke HF incidence rates in older stroke survivors (aged 60 years) over an 11 year period (between 1999/2000 and 2009/2010). Projections of number of post-stroke HF in 2021 and 2051 are based on demographic predictors obtained from the Australian Bureau of Statistics. RESULTS: Over the study period among 1784 stroke survivors HF was recorded in 61 (3.42%) subjects (40 women and 21 men), indicating a HF incidence rate of 6.31 per 1000 stroke person-years. The standardized annual post-stroke HF incidence rate (per 100,000 person-years) in women was 1.7 times higher than in men (18.9 vs. 11.1 per, p = 0.008), and in the oldest group (80 years) compared to aged 60-69 years was 10 times higher for women (47.54 vs. 4.73) and 4 times higher for men (26.65 vs. 6.50). Post-stroke HF occurred on average within the first 2.3 years, about 2 times more often in women aged 75 years (p = 0.033) and in survivors after an ischaemic stroke (p = 0.052), but age per se did not affect the time to HF. During the 11-year period the incidence rates of post-stroke HF decreased annually in total by 17.9%. CONCLUSIONS: Post-stroke HF is relatively common, prevalent in women and occurs on average within 2.3 years after the stroke. The incidence of post-stroke HF in elderly people is decreasing. However, because of population ageing and increasing number of stroke survivors, the absolute number of post-stroke patients sustaining a HF and their proportion among the total HF population could be expected to increase.