The University of Southampton
University of Southampton Institutional Repository

Secular trends in fracture incidence in the UK between 1990 and 2012

Secular trends in fracture incidence in the UK between 1990 and 2012
Secular trends in fracture incidence in the UK between 1990 and 2012
Summary: We studied sex-specific incidence rates in a population 50 years or older in the UK. In the period of 1990–2012, the overall rate of fracture did not change, but there were marked secular alterations in the rates of individual fracture types, particularly hip and spine fractures in the elderly.

Introduction: There is increasing evidence of secular changes in age- and sex- adjusted fracture incidence globally. Such observations broadly suggest decreasing rates in developed countries and increasing rates in transitioning populations. Since altered fracture rates have major implications for healthcare provision and planning, we investigated secular changes to age- and sex-adjusted fracture risk amongst the UK population aged 50 years or above from 1990 till 2012.

Methods: We undertook a retrospective observational study using the Clinical Practice Research Datalink (CPRD), which contains the health records of 6.9 % of the UK population. Site-specific fracture incidence was calculated by calendar year for men and women separately, with fracture type categorised according to ICD-9 classification. Linear regression analysis was used to calculate mean annualised change in absolute incidence. For presentational purposes, mean rates in the first 5 years and last 5 years of the period were calculated.

Results: Overall fracture incidence was unchanged in both women and men from 1990 to 2012. The incidence of hip fracture remained stable amongst women (1990–1994 33.8 per 10,000 py; 2008–2012 33.5 per 10,000 py; p trend annualised change in incidence?=?0.80) but rose in men across the same period (10.8 to 13.4 per 10,000 py; p?=?0.002). Clinical vertebral fractures became more common in women (8.9 to 11.8 per 10,000 py; p?=?0.005) but remained comparable in men (4.6 to 5.9 per 10,000 py; p?=?0.72). Similarly, the frequency of radius/ulna fractures did not change in men (9.6 to 9.6 per 10,000 py; p?=?0.25), but, in contrast, became less frequent in women (50.4 to 41.2 per 10,000 py; p?=?0.001). Secular trends amongst fractures of the carpus, scapula, humerus, foot, pelvis, skull, clavicle, ankle, patella, and ribs varied according to fracture site and sex.

Conclusion: Although overall sex-specific fracture incidence in the UK population 50 years or over appears to have remained stable over the last two decades, there have been noticeable changes in rates of individual fracture types. Given that the impact of a fracture on morbidity, mortality, and health economy varies according to fracture site, these data inform the provision of healthcare services in the UK and elsewhere.
0937-941X
3197-3206
van der Velde, R.Y.
fb7773ca-97e5-4650-994f-f98825c9c7cd
Wyers, C.E.
3fe3e040-7070-476b-a0f1-bb4cac288886
Curtis, E.M.
92beef1b-f012-4398-861c-e1156b2adfee
Geusens, P.P.M.M.
283a5cbd-bd2c-4a19-8549-24f24b3bf0ad
van den Bergh, J.P.W.
c30fc1ae-c65a-4c7e-a71f-cfd251a8b8b5
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
van Staa, T.P.
31b8bfb4-4e1b-4a48-a5a6-90ca601b94af
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
van der Velde, R.Y.
fb7773ca-97e5-4650-994f-f98825c9c7cd
Wyers, C.E.
3fe3e040-7070-476b-a0f1-bb4cac288886
Curtis, E.M.
92beef1b-f012-4398-861c-e1156b2adfee
Geusens, P.P.M.M.
283a5cbd-bd2c-4a19-8549-24f24b3bf0ad
van den Bergh, J.P.W.
c30fc1ae-c65a-4c7e-a71f-cfd251a8b8b5
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
van Staa, T.P.
31b8bfb4-4e1b-4a48-a5a6-90ca601b94af
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145

van der Velde, R.Y., Wyers, C.E., Curtis, E.M., Geusens, P.P.M.M., van den Bergh, J.P.W., de Vries, F., Cooper, C., van Staa, T.P. and Harvey, N.C. (2016) Secular trends in fracture incidence in the UK between 1990 and 2012. Osteoporosis International, 27 (11), 3197-3206. (doi:10.1007/s00198-016-3650-3). (PMID:27283403)

Record type: Article

Abstract

Summary: We studied sex-specific incidence rates in a population 50 years or older in the UK. In the period of 1990–2012, the overall rate of fracture did not change, but there were marked secular alterations in the rates of individual fracture types, particularly hip and spine fractures in the elderly.

Introduction: There is increasing evidence of secular changes in age- and sex- adjusted fracture incidence globally. Such observations broadly suggest decreasing rates in developed countries and increasing rates in transitioning populations. Since altered fracture rates have major implications for healthcare provision and planning, we investigated secular changes to age- and sex-adjusted fracture risk amongst the UK population aged 50 years or above from 1990 till 2012.

Methods: We undertook a retrospective observational study using the Clinical Practice Research Datalink (CPRD), which contains the health records of 6.9 % of the UK population. Site-specific fracture incidence was calculated by calendar year for men and women separately, with fracture type categorised according to ICD-9 classification. Linear regression analysis was used to calculate mean annualised change in absolute incidence. For presentational purposes, mean rates in the first 5 years and last 5 years of the period were calculated.

Results: Overall fracture incidence was unchanged in both women and men from 1990 to 2012. The incidence of hip fracture remained stable amongst women (1990–1994 33.8 per 10,000 py; 2008–2012 33.5 per 10,000 py; p trend annualised change in incidence?=?0.80) but rose in men across the same period (10.8 to 13.4 per 10,000 py; p?=?0.002). Clinical vertebral fractures became more common in women (8.9 to 11.8 per 10,000 py; p?=?0.005) but remained comparable in men (4.6 to 5.9 per 10,000 py; p?=?0.72). Similarly, the frequency of radius/ulna fractures did not change in men (9.6 to 9.6 per 10,000 py; p?=?0.25), but, in contrast, became less frequent in women (50.4 to 41.2 per 10,000 py; p?=?0.001). Secular trends amongst fractures of the carpus, scapula, humerus, foot, pelvis, skull, clavicle, ankle, patella, and ribs varied according to fracture site and sex.

Conclusion: Although overall sex-specific fracture incidence in the UK population 50 years or over appears to have remained stable over the last two decades, there have been noticeable changes in rates of individual fracture types. Given that the impact of a fracture on morbidity, mortality, and health economy varies according to fracture site, these data inform the provision of healthcare services in the UK and elsewhere.

Text
CPRD secular trends R1 04052016 clean.docx - Accepted Manuscript
Download (124kB)
Slideshow
CPRD Secular Trends OI 04052016 R1 Figure 1 to 3.pptx - Other
Download (1MB)

More information

Accepted/In Press date: 23 May 2016
e-pub ahead of print date: 9 June 2016
Published date: November 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 396868
URI: http://eprints.soton.ac.uk/id/eprint/396868
ISSN: 0937-941X
PURE UUID: 21e12aa7-d10e-4850-947c-02e6d8630422
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for N.C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 15 Jun 2016 10:16
Last modified: 07 Oct 2020 04:21

Export record

Altmetrics

Contributors

Author: R.Y. van der Velde
Author: C.E. Wyers
Author: E.M. Curtis
Author: P.P.M.M. Geusens
Author: J.P.W. van den Bergh
Author: F. de Vries
Author: C. Cooper ORCID iD
Author: T.P. van Staa
Author: N.C. Harvey ORCID iD

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×