Epidemiology of major osteoporotic fractures: a population-based analysis in Catalonia, Spain

The aim of this study was to estimate the incidence of major osteoporotic fractures in Catalonia, Spain, in 2018 and 2019 and their association with age, sex, income, climate and a set of comorbidities.

Data on age, sex, smoking, alcohol abuse, comorbidities (obesity, Parkinson's disease, arthritis, chronic kidney disease, hepatic cirrhosis, diabetes, chronic obstructive pulmonary disease, dementia, cerebrovascular disease, hyperthyroidism, multiple myeloma and epilepsy) and income levels in people aged ≥ 50 years with a new diagnosis of major osteoporotic fractures in 2018 and 2019 were collected from the Catalan Health Surveillance System (CHSS). Climatological variables were obtained from the Catalan Meteorological Service. Incidence rates were estimated for five major osteoporotic fractures (MOF). Associations between osteoporotic fractures and age, sex, income, comorbidities and climate variables were ascertained through multilevel generalized linear model analysis (Poisson's regression).

There were 60,671 MOF. The annual incidence rate per 1000 persons/years at risk (PYAR) was 10.6 (3.1 for hip, 2.3 for distal forearm, 2.2 for vertebrae, 1.7 for pelvis and 1.5 for proximal humerus). Female sex, older age, lower income, smoking, alcohol abuse and some common comorbidities were associated with a higher incidence of MOF while obesity was a protective factor.

MOF are frequent in the adult Catalan population, especially in older women and people on low incomes. Hip fracture is the most frequent, followed by forearm and vertebral fractures. Smoking, alcohol abuse and some comorbidities were associated with an increased incidence of fracture.