Prevalence of Fragility Fractures

 
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V.B.1

Lead Author(s): 

Sylvia I. Watkins-Castillo, PhD
Nicole C. Wright, PhD, MPH

There is no one national database that captures the number of all hip and spinal fractures and estimates how many additional people have fractures without BMD-defined osteoporosis. The Centers for Disease Control and Prevention have estimated at least 250,000 people age 65 years and older are hospitalized for hip fractures each year, using the National Hospital Discharge Survey (NHDS). Nearly all (95%) hip fractures are caused by falling, usually falling sideways.1

Another comprehensive database for evaluation of the total number of hospitalized fractures is the Agency for Healthcare Research and Quality’s (AHRQ) Nationwide Inpatient Sample (NIS), and is used throughout this site to estimate burden. The NIS includes more than 8 million inpatient hospitalizations each year from all payers in the United States, and is representative of 95% of all hospitalizations in the US. Among women 55 years and older, there were almost 1.7 million hospitalizations for fragility fractures in 2011. Hip fractures were the most common (23%) fractures requiring hospitalization, representing 325,200 hip fractures. Hospitalizations for clinically evident spine fractures (8.4%), representing 245,800 patients, was the second most common type of fragility fracture. For 92% of hospitalizations for hip fracture, this was the primary, or first, diagnosis; for spine fractures, 46% were the primary diagnosis. (Reference Table 5.2.1 PDF CSV)

Hospitalizations for Fragility Fracture Diagnosis, United States 2011

Relying on hospitalized fractures may underestimate the true prevalence of fragility fractures in the United States, since many fractures do not require hospital treatment and approximately two-thirds of all vertebral fractures are not clinically diagnosed.2 An analysis of the AHRQ NIS and National Emergency Department Sample (NEDS), and the CDC National Center for Health Statistics National Hospital Ambulatory Medical Care Survey (NHAMCS–Outpatient) and National Ambulatory Medical Care Survey (NAMCS–Physician Offices) for the years 2010 and 2011, showed 4.3 million fragility fracture visits, of which only 18% were hospital discharge visits. Wrist and arm fractures are the most likely fragility fractures to be treated outside a hospital. (Reference Table 5.2.1 PDF CSV)

Health Care Visits with Diagnosis of Fragility Fracture for Persons Age 50 and Over, United States 2010-2011

  • 1. Centers for Disease Control and Prevention: Home and Recreational Safety. Hip Fractures Among Older Adults.Available at: http://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html. Accessed September 29, 2015.
  • 2. Singer A, Exuzides A, Spangler L. et al.: Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States. Mayo Clin Proc 2015 Jan;90(1):53-62. doi: 10.1016/j.mayocp.2014.09.011. Epub 2014 Dec 4.

Edition: 

  • 2014

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