Abstract

Presentation Number: 1739

Carlos H. Orces1, Shuko Lee2. 1South Texas Veterans Health System, Laredo, TX; 2South Texas Veterans Health System, Laredo and San Antonio, TX

Hip fracture is an important cause of morbidity and mortality and represents a major public health problem. Because of the aging population, the number of hip fracture is expected to increase in US.

Purpose: To describe recent hospitalization and in-hospital mortality trends for hip fracture in US.

Methods: We used data from the National Hospital Discharge Survey, which includes discharges from noninstitutional hospitals, exclusive of federal, military, and Veterans Administration hospitals. Patients were defined as having a hip fracture if one of the seven discharge diagnosis code (ICD-9-CM) was 820. Population estimates for US by age, sex and race were obtained from the Census Bureau. Age-specific hip fracture hospitalization rates for ages 50 years through 85 and older were calculated for each year. The age-adjusted rate was calculated by the direct method using the US 2000 population as the standard. In-hospital case-fatality rate was calculated as the percent of patients who died during hospitalization following a hip fractures by age (65 to 74, 75 to 84, and >85) and sex.

Results: A total of 895,167 men and 2,747,962 women were admitted to the hospital with a diagnosis of hip fracture during the study period. Hip fracture was recorded as the principal diagnosis at discharge in 87% of men and 90% of women. Following a hip fracture, 41% of men and 45% of women were discharged to a long-term facility. For women, the age-adjusted rates were two-fold greater than those in men. Women showed an increase of 8.5% and men a decrease of 17% in fracture rates from 1990 to 2000. The highest increase in rates was observed in black men (121%) and women (27%). Hip fracture rates decreased 24% and 2.7% for white men and women, respectively (Fig 1). In-hospital mortality rates following hip fractures decreased significantly for men and women during the past decade. Trends toward decreasing mortality were observed in men ages 65 years through 85 and older. In-hospital mortality also decreased in women ages 65 years through 85, however, the annual mortality for women ages 65 to 74 increased 0.03% (Fig 2).
Conclusions: Although in-hospital survival following hip fractures improved during the past decade, hospitalization for hip fracture continues to be a public health problem that may reach epidemic proportions in US unless measures to prevent falls and osteoporosis are implemented.

Disclosure: C.H. Orces, None; S. Lee, None.

Note: Figures 1 and 2 can be found on the [OASIS] Web site.