Trends in Incidence of Subtrochanteric Fragility Fractures and Bisphosphonate Use Among the US Elderly, 1996–2007
2011

Trends in Subtrochanteric Fragility Fractures and Bisphosphonate Use in the Elderly

Sample size: 90700000 publication Evidence: moderate

Author Information

Author(s): Wang Zhong, Bhattacharyya Timothy

Primary Institution: Intramural Research Program, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health

Hypothesis

The study aims to analyze national trends in hip fractures and medication use among the elderly US population from 1996 to 2007.

Conclusion

The study found that while typical hip fractures decreased, subtrochanteric fragility fractures increased among postmenopausal women during the same period.

Supporting Evidence

  • Typical hip fractures decreased by 31.6% among women and 20.5% among men from 1996 to 2007.
  • Bisphosphonate use increased from 3.5% in 1996 to 16.6% in 2007 among women.
  • Subtrochanteric fragility fractures increased 20.4% among women from 1999 to 2007.

Takeaway

As older people are getting fewer typical hip fractures, there are more cases of a rare type of hip fracture called subtrochanteric fractures, especially in older women who take a medicine called bisphosphonates.

Methodology

The study used data from the Nationwide Inpatient Sample (NIS) and the Medical Expenditure Panel Survey (MEPS) to analyze trends in hip fractures and bisphosphonate use.

Potential Biases

The study may have overestimated subtrochanteric fractures due to reliance on ICD-9 codes rather than radiographic evidence.

Limitations

The study may not represent the same segment of the US population, and data on lifestyle factors that could explain fracture trends were not available.

Participant Demographics

The study focused on elderly patients aged 65 and older, with a higher percentage of subtrochanteric fractures in women and a significant number of patients with comorbid conditions.

Statistical Information

P-Value

p < 0.001

Confidence Interval

95% CI 27.7–29.1

Statistical Significance

p < 0.05

Digital Object Identifier (DOI)

10.1002/jbmr.233

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