Burden of osteoporotic fractures in primary health care in Catalonia (Spain): A population-based study

Aina Pagès-Castell, Cristina Carbonell-Abella, Francesc Fina Avilés, Maite Alzamora, Jose Miguel Baena-Díez, Daniel Martínez Laguna, Xavier Nogués, Adolfo Díez-Pérez, Daniel Prieto-Alhambra

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Abstract

Background: Knowledge on the epidemiology of non-hip fractures in Spain is limited and somewhat outdated. Using computerized primary care records from the SIDIAP database, we derived age and sex-specific fracture incidence rates for the region of Catalonia during the year 2009. Methods. The SIDIAP database contains quality-checked clinical information from computerized medical records of a representative sample of >5,800,000 patients (80% of the population of Catalonia). We conducted a retrospective cohort study including all patients aged 50years, and followed them from January 1 to December 31, 2009. Major osteoporotic fractures registered in SIDIAP were ascertained using ICD-10 codes and validated by comparing data to hospital admission and patient-reported fractures records. Incidence rates and 95% confidence intervals were calculated. Results: In total, 2,011,430 subjects were studied (54.6% women). Overall fracture rates were 10.91/1,000 person-years (py) [95%CI 10.89-10.92]: 15.18/1,000 py [15.15-15.21] in women and 5.78/1,000 py [5.76-5.79] in men. The most common fracture among women was wrist/forearm (3.86/1,000 py [3.74-3.98]), while among men it was clinical spine (1.25/1,000 py [1.18-1.33]). All fracture rates increased with age, but varying patterns were observed: while most of the fractures (hip, proximal humerus, clinical spine and pelvis) increased continuously with age, wrist and multiple rib fractures peaked at age 75-80 and then reached a plateau. Conclusions: Our study provides local estimates of age, sex and site-specific fracture burden in primary health care, which will be helpful for health-care planning and delivery. A proportion of fractures are not reported in primary care records, leading to underestimation of fracture incidence rates in these data. © 2012 Pagès-Castell et al.; licensee BioMed Central Ltd.
Original languageEnglish
Article number79
JournalBMC Musculoskeletal Disorders
Volume13
DOIs
Publication statusPublished - 29 May 2012

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    Pagès-Castell, A., Carbonell-Abella, C., Avilés, F. F., Alzamora, M., Baena-Díez, J. M., Laguna, D. M., Nogués, X., Díez-Pérez, A., & Prieto-Alhambra, D. (2012). Burden of osteoporotic fractures in primary health care in Catalonia (Spain): A population-based study. BMC Musculoskeletal Disorders, 13, [79]. https://doi.org/10.1186/1471-2474-13-79