Fractures: Vast Geographic Differences

Fractures…they’re all over the map. The International Osteoporosis Foundation (IOF) Working Group on Epidemiology and Quality of Life has just completed a study of country-specific risk of hip fracture and 10-year probability of a major fragility fracture. Even accounting for possible errors or limitations in the source data, there was a 10-fold variation in hip fracture risk and fracture probability between countries. The researchers have used the data from the study to formulate all-new online global hip fracture incidence and 10-year fracture probability maps.

The team found that the highest risk countries for both genders are in North Western and Central Europe. High risk countries outside of Europe include Lebanon, Oman, Iran, Hong Kong, Singapore, and Taiwan. In the U.S., ethnic-specific rates place Caucasian women at high risk, whereas Hispanic, Asian and Black populations are at low risk.

The study, “A systematic review of hip fracture incidence and probability of fracture worldwide,” utilized age-standardized hip fracture rates from 63 countries. Additionally, the study documents variations in major fracture probability as determined from 45 FRAX models from 40 countries.

In women, the lowest annual age-standardized incidences were found in Tunisia and Ecuador with 58 and 73 per 100,000 persons respectively. The highest incidences were in Northern European countries, with 574 and 563 per 100,000 in Denmark and Norway respectively.

Within countries, the age-standardised incidence of hip fracture in men was approximately half that noted in women. Where higher rates were observed in women, higher rates were generally found in men and vice versa. Geographic patterns were similar for men and women, although there was a notable difference in Russia where women are shown as moderate risk, men as high.

In the March 21, 2012 news release, IOF President John A. Kanis stated, “These are the first visual, interactive, and referenced maps which depict the burden of hip fractures and FRAX-derived 10-year fracture probabilities. The maps will be a valuable resource for researchers, students, health policy officials or others who require epidemiological data and comparative statistics on osteoporotic fractures.”

Professor Kanis told OTW,

Only by identifying the size of the problem – totally, comparatively, and in individual countries and regions – will we be able to take steps to tackle the problem. Why are there such disparities in hip fracture rates around the world and even within single regions, such as Europe? We believe that this kind of data will open up new avenues of enquiry by investigators, and inform health policy officials about the burden of the disease in their countries.

The global hip fracture incidence and 10-year fracture probability maps will soon be finalized on the International Osteoporosis Foundation website.




Josh Sandberg

Josh Sandberg is the President of Ortho Spine Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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