Incidence and outcome of osteoporotic fractures in 2004 in Sado City, Niigata Prefecture, Japan

Abstract

Osteoporotic fracture in elderly populations is increasing worldwide, but there are few data on the incidence and outcome of osteoporotic fractures, including upper extremity and vertebral fracture, during a certain period in a defined geographic area. The purpose of this study was to determine the incidence of osteoporotic fractures in a particular area: Sado City, Niigata Prefecture, Japan. From January to December 2004, osteoporotic fractures of the vertebra, hip, distal radius, and proximal humerus in Sado City were recorded. The incidence, age, gender, type of fracture (for hip fracture), right or left side (for distal radius, proximal humerus, and hip fracture), place of injury, cause of injury, outcome, hospitalization period, and patient status regarding taking of drugs for osteoporosis treatment were checked for each fracture. The incidence was calculated based on the whole population of Sado City. The incidence per 100,000 population was 232.8, 121.4, 108.6, and 37.1 for fractures of the vertebra, hip, distal radius, and proximal humerus, respectively. The total incidence of these four kinds of fracture was 499.9 per 100,000 persons per year. The average age at the time of injury was 81.4, 77.7, 75.7, and 60.2 years old for fractures of the hip, vertebra, proximal humerus, and distal radius, respectively. As the average age increased, the percentage of fractures that occurred indoors also increased; that is, a higher percentage of hip fractures occurred indoors, followed by fractures of the vertebra, proximal humerus, and distal radius. Most patients were not taking anti-osteoporosis drugs before fractures of the hip or vertebra. We determined the incidence of major osteoporotic fractures in 1 year in a defined geographic area. Our data showed that 81% of hip fracture patients also had a vertebral fracture and that the average age at the time of injury was higher for hip fractures than for vertebral fractures. Therefore, these results suggest that vertebral fracture leads to hip fracture, indicating that early fracture prevention and continuous prevention strategies through positive treatment are of importance in osteoporotic elderly people.

Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008

“…Despite the incidence of falls in men being more frequent than in women among community-dwelling older adults (30), it was clear that women experienced more humerus fractures (per population size) and this finding is consistent with those of other studies (17,18,22,31). As low bone mineral density is the strongest predictor of humerus fractures, we believe that this statistic is due to the high prevalence of osteoporosis among elderly women.…”

“…Although the incidence rate of humeral fractures among elderly patients in the US is not increasing (13), the rate of humerus fractures in the US is considerably higher than that of countries with a larger proportion of elderly persons in the population. Epidemiologic studies suggest that the annual incidence rates of humerus fractures in the US are higher than those in Japan and European countries (15)(16)(17)(18)(19)(20)(21)(22) (Table 2). Finland is considered to be a country with high fragility fracture rates (23).…”

Fracture incidence in nursing homes in Japan

“…Morita et al [12] studied the prefecture-wide hip fracture incidence in Niigata (population, 2,486,999), and Sakuma et al [13] studied hip fracture incidence in Sado City (population, 70,011) in Niigata Prefecture. When their data for women were ageadjusted to our study population, hip fracture incidence was calculated to be 9.7 and 9.9 per 1,000 person-years, in studies by Morita et al [12] and Sakuma et al [13], respectively. In comparison, hip fracture incidence in women in our study (14.9 per 1,000 person-years) was about 1.5-fold higher.…”

“…For limb fractures, Sakuma et al [13] determined the incidence of fracture of the distal radius and proximal humerus in the general population, and the incidence in women, age-adjusted to our study population, was calculated to be 2.4 per 1,000 person-years for distal radius fracture and 2.5 per 1,000 person-years for proximal humerus fracture. Hagino et al [17] also investigated arm fractures in the female general population in Japan, and the incidence rate age-adjusted to our population was 4.0 distal radius fractures per 1,000 person-years and 2.2 proximal humerus fractures per 1,000 person-years.…”

Incidence and Mortality of Hip Fractures in the United States

“…49 Despite the decreases in hip fracture incidence that we documented, the current incidence of hip fracture is still higher than that seen in other countries. 26,32,34,49,50 It appears that while improvements have been made in the incidence of hip fracture, there is still ample room for further gains.…”