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A Modeling Study for Hip Fracture Rates in Romania
Flaviu Moldovan1, Liviu Moldovan2
1Orthopedics-Traumatology Department, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Journal of Clinical Medicine
|May 14, 2025
Summary
Hip fracture incidence increased due to lifestyle factors like higher BMI, less activity, and smoking, despite some benefit from osteoporosis medication. Prevention policies should target these modifiable risk factors for greater fracture reduction.
Area of Science:
- Gerontology
- Epidemiology
- Public Health
Background:
- The global population is aging, leading to an anticipated rise in hip fracture incidence.
- Effective prevention strategies necessitate a clear understanding of the determinants contributing to hip fracture rates.
Purpose of the Study:
- To quantify the impact of osteoporosis treatments and temporal changes in major risk factors on hip fracture incidence variation.
- To analyze trends in risk factors and their contribution to hip fracture rates in Romania between 2008 and 2018.
Main Methods:
- Utilized the HIP-IMPACT model, a validated epidemiological tool, for a national study in Romania.
- Analyzed national data from 2008-2018, including hip fracture incidence by sex, prevalence of osteoporosis treatments, and key risk factors.
- Incorporated data on body mass index (BMI), physical activity, smoking, type 2 diabetes, and medication use (z-drugs, glucocorticoids, opioids, benzodiazepines).
Main Results:
- The HIP-IMPACT model successfully explained 90.1% of the variation in hip fracture rates.
- Increased BMI (36.8%), decreased physical activity (29.3%), and increased smoking prevalence (29.1%) were major contributors to fracture incidence.
- Other contributing factors included type 2 diabetes, z-drug, glucocorticoid, and opioid use, partially offset by increased osteoporosis medication uptake and reduced benzodiazepine use.
Conclusions:
- Osteoporosis medications reduced hip fractures by approximately 12.5% between 2008 and 2018.
- Modifiable risk factors collectively increased hip fracture incidence by about 75% during the same period.
- Significant potential exists for fracture prevention through enhanced pharmacological treatment and public health policies addressing physical activity, smoking, and BMI.
