Do we need orthogeriatrics in Poland? Changes in the age structure and location of hip fractures

One year of the COVID-19 pandemic in Poland-the incidence of osteoporotic forearm, arm, and hip fractures

The study attempts to analyse whether the COVID-19 pandemic affected the incidence of forearm, arm, and hip fractures during a 1-year observation period. Additionally, changes in the overall treatment costs of those fractures were estimated. During the COVID-19 pandemic, the incidence of forearm, arm, and hip fractures remained statistically unchanged, neither were any significant changes observed in the expenditure, incurred for the treatment of the fracture cases.

PURPOSE

The purpose of the study was to find out and evaluate if the consequences of COVID-19 pandemic (including lockdown and the fear of infection) influenced the incidence of osteoporotic forearm, arm, and hip fractures and to estimate the changes in the costs of their management during one-year observation period.

METHODS

The incidence of forearm, arm, and hip fractures was collected for the population, aged ≥ 50, residing at the district of Tarnowskie Góry and the Town of Piekary Śląskie, Poland, during 1 year of COVID-19 pandemic (from March 16th 2020 to March 15th 2021). The obtained results were compared with the number of corresponding limb fractures, recorded before the pandemic during five consecutive yearly periods, each starting from 16th March and ending on the 15th March of a subsequent year, the entire period covering the years 2015-2020. The rates of the analysed fractures were calculated per 100,000 inhabitants together with their economic impact.

RESULTS

The mean numbers and the incidence rates of upper extremity fractures were slightly lower during the COVID-19 pandemic than in the previous 5 years, whereas hip fracture figures remained almost stable. The observed changes were not statistically significant. That annual observation revealed a slight decrease in expenditure volumes, when compared to the analysed period before the pandemic (-0.33%).

CONCLUSION

The decreased incidence rate of forearm, arm, and hip fractures, observed during the first months of the COVID-19 pandemic, was not statistically significant in the 1-year observation. After several weeks/months under the shock, caused by government limitations and the fear of infection, the number of patients remained unchanged during the one-year observation.

The Increase of Osteoporotic Hip Fractures and Associated One-Year Mortality in Poland: 2008-2015

INTRODUCTION

Hip fractures are a worldwide public health issue associated with significant mortality. Previous Polish studies reported an increasing trend in the number of hip fractures for both men and women, although lower than most other European countries.

MATERIALS AND METHODS

The Polish National Database was analyzed to examine osteoporotic hip fractures in the population aged 50 and over. Hip fracture incidence, rate, one-year mortality, and postoperative length of hospitalization were analyzed using the national health system data. Hospital discharge registry ICD-10 codes were reviewed from 2008 to 2015.

RESULTS

The incidence of hip fractures increased in both women and men by 19.4% and 14.2%, respectively. The female to male fracture ratio was 2.46. Mean postoperative hospitalization decreased from 13.6 to 11.2 days. The one-year mortality ranged between 30.45% to 32.8% for men and 26.2% to 28% for women. Of note, women aged 80-89 had the highest one-year mortality, 50.7%-55.4% after femoral neck fracture and 53%-58.5% after a pertrochanteric fracture.

CONCLUSIONS

Hip fractures in Poland are increasingly more prevalent in the aging population. The unfavorable trends observed in this study indicate higher annual mortality after hip fracture, compared with other European countries.