Epidemiology of osteoporotic hip fractures in Western Romania

Fragility hip fractures represent a major health and social burden. To date, there are no reports regarding mortality and factors that influence outcomes after osteoporotic hip fractures in Romania.

The electronic database of the largest healthcare provider in the western part of the country was searched for hip fracture admissions between 2008 and 2012. Inclusion criteria were age over 55 and the diagnosis of intra or extracapsular fractures, corresponding to ICD-10 S72.0 and S72.1 codes, respectively.

A total of 1,866 patients met the criteria and were selected for data analysis. The gain in rates and crude numbers was caused mainly by a rise of fractures in males. The opposite is seen for the female-to-male ratio. Even though the mean age steadily increased for a total of 1.5 over a five-year period the patients are still younger than the European averages, which might explain the slightly better one-year survival. The age-gender adjusted hip fracture incidence increased dramatically with age, especially in women. The relative risk of dying in the first year is 1.359 times higher if the fracture is extracapsular (95% CI 1.12-1.65). In total, 21.1% of all patients die by one year after the fracture. This was drastically reduced for the following years. The survival function is significantly dependent on age group, level of fracture and time from hospital admission until surgery (p < 0.001).

Increased age, extracapsular fractures and delayed surgery have worse outcomes. Regarding gender, even if not significant at the 0.05 level, probability of survival for females is higher for all time intervals. Updated, regional studies could be used in patient management to improve outcomes whilst decreasing costs.