Prospective Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2014; 5(3): 386-391
Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.386
Ten years of hip fractures in Italy: For the first time a decreasing trend in elderly women
Prisco Piscitelli, Maurizio Feola, Cecilia Rao, Monica Celi, Elena Gasbarra, Cosimo Neglia, Giuseppe Quarta, Federico Maria Liuni, Simone Parri, Giovanni Iolascon, Maria Luisa Brandi, Alessandro Distante, Umberto Tarantino
Prisco Piscitelli, Cosimo Neglia, Giuseppe Quarta, Alessandro Distante, Euro Mediterranean Scientific Biomedical Institute, ISBEM Research Centre, 72023 Brindisi, Italy
Prisco Piscitelli, Cosimo Neglia, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy
Maurizio Feola, Cecilia Rao, Monica Celi, Elena Gasbarra, Federico Maria Liuni, Umberto Tarantino, Division of Orthopaedics and Traumatology, University of Tor Vergata, 00133 Rome, Italy
Simone Parri, Maria Luisa Brandi, Department of Translational Medicine, University of Florence, 50134 Florence, Italy
Giovanni Iolascon, Department of Orthopaedics and Rehabilitative Medicine, Second University of Naples, 80138 Naples, Italy
Author contributions: Piscitelli P, Feola M, Rao C, Celi M, Neglia C, Quarta G, Distante A, Brandi ML and Tarantino U have conceived of the study, and participated in its design and coordination, and helped to draft the manuscript. Piscitelli P, Feola M, Rao C, Celi M, Gasbarra E, Neglia C, Quarta G, Liuni FM, Parri S, Iolascon G, Distante A, Brandi ML and Tarantino U all participated to draft the manuscript and performed all the analyses and statistics of the paper; all authors read and approved the final manuscript.
Supported by Consulting/speaking by Sanofi-Aventis, AMGEN, Servier, Eli-Lilly, Abiogen to Piscitelli P; Research grant and funding for consulting/speaking by Merck, Sanofi-Aventis, Novartis, Stroder-Servier, Procter and Gamble, Ely Lilly, Roche, Glaxo to Brandi ML and Tarantino U
Correspondence to: Prisco Piscitelli, MD, Euro Mediterranean Scientific Biomedical Institute, ISBEM Research Centre, c/o ISBEM, via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy. prisco.piscitelli@tiscali.it
Telephone: +39-0831-713511 Fax: +39-0831-713569
Received: October 8, 2013
Revised: March 16, 2014
Accepted: April 11, 2014
Published online: July 18, 2014
Abstract

AIM: To evaluate the hospitalization rate of femoral neck fractures in the elderly Italian population over ten years.

METHODS: We analyzed national hospitalizations records collected at central level by the Ministry of Health from 2000 to 2009. Age- and sex-specific rates of fractures occurred at femoral neck in people ≥ 65 years old. We performed a sub-analysis over a three-year period (2007-2009), presenting data per five-year age groups, in order to evaluate the incidence of the hip fracture in the oldest population.

RESULTS: We estimated a total of 839008 hospitalizations due to femoral neck fractures between 2000 and 2009 in people ≥ 65, with an overall increase of 29.8% over 10 years. The incidence per 10000 inhabitants remarkably increased in people ≥ 75, passing from 158.5 to 166.8 (+5.2%) and from 72.6 to 77.5 (+6.8%) over the ten-year period in women and men, respectively. The oldest age group (people > 85 years old) accounted for more than 42% of total hospital admissions in 2009 (n = 39000), despite representing only 2.5% of the Italian population. Particularly, women aged > 85 accounted for 30.8% of total fractures, although they represented just 1.8% of the general population. The results of this analysis indicate that the incidence of hip fractures progressively increased from 2000 to 2009, but a reduction can be observed for the first time in women ≤ 75 (-7.9% between 2004 and 2009).

CONCLUSION: Incidence of hip fractures in Italy are continuously increasing, although women aged 65-74 years old started showing a decreasing trend.

Keywords: Femoral fractures, Hip fragility fractures, Osteoporosis, Hospitalizations, Incidence

Core tip: We evaluated hospitalization rate of femoral neck fractures in the elderly Italian population over ten year-period (from 2000 to 2009). Our data confirm the dramatic social impact of hip fractures in the elderly, although the perception of their clinical and social relevance is still limited in public and medical profession. Despite this, for the first time a reduction in the number of hospitalizations for women aged 65-74 resulted.