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[Epidemiology of hip fracture in Asturias].

BACKGROUND
Hip fracture is the complication with the greatest medical repercussions in osteoporosis. The aim of this study was to know both the incidence of osteoporotic hip fracture in Asturias, Spain and the immediate evolution of these patients.


METHODS
The clinical histories of all the patients admitted for hip fracture in 1992 in two Asturian public health care areas were reviewed. Hip fractures in patients under the age of 45 years or those occurring because of other diseases (metastasis, serious injury) were excluded.


RESULTS
In the health care areas studied in 1992 there were 283 osteoporotic hip fractures with an incidence of 219.6 fractures/10(5) inhabitants/year in those over the age of 50 years. The incidence in women over 45 years of age was 3-fold greater than that in men of the same age. The mean age of the patients was 80.2 +/- 8.9 years. The incidence in people over the age of 50 was greater in urban (266/10(5) inhab./year) than in the rural areas (185.7/10(5) inhab./year) (p < 0.001). Ten percent of the patients were residing in old age residences or hospitals at the time of the fracture. Eighty-one percent required surgery. Home was the site of the fracture in 84% of the cases with no seasonal variation being observed. The most frequent intrahospitalary complications observed were infections (15%), cardiac or respiratory disturbances (18%), and confusion (8%). The mean hospital stay was 26.5 days with acute hospitalary mortality of 5.6%. Nineteen point seven percent of the patients were transferred to a center for chronically ill people. The total cost of the hospital care for the hip fractures in this study exceeded 311 million pesetas in 1992.


CONCLUSIONS
The epidemiology of osteoporotic hip fracture in Asturias, Spain, follows a similar pattern as that found in other Spanish regions. It was found to be more frequent in the urban than in the rural areas. Hospitalary mortality of these patients is partly determined by age and the number of complications which developed during hospital stay. The impact on the patients with osteoporotic hip fracture and on the economic resources destined to their attention justifies the development of osteoporosis and fracture prevention programs.