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Age Ageing. 2017 Mar 1;46(2):324-328. doi: 10.1093/ageing/afw196.

Secular trend in the incidence of hip fracture in Catalonia, Spain, 2003-2014.

Author information

Department of Health, Master Plan of Musculoskeletal Diseases, Barcelona, Spain.
Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona.
Rheumatology Department, Fundacio Parc Tauli - Institut Universitari UAB, Sabadell, Catalunya, Spain.
Rheumatology Department, Fundacio Hospital Asil de Granollers, Granollers, Catalunya, Spain.
School of Medicine and Health Sciences, International University of Catalonia, Sant Cugat del Valles, Catalunya, Spain.
Orthopaedic Department, Hospital de Mataro, Mataro, Catalunya, Spain.
Department of Economic Analysis, Studies and Prospective, Catalan Union of Hospitals, Barcelona, Spain.
Department of Economics,Pompeu Fabra University, Barcelona, Spain.



to describe the secular trend and seasonal variation in the incidence of hip fracture (HF) over 12 years (2003-2014) in Catalonia, the community with the highest incidence of HF in Spain.


data about age, gender, type of fracture and month of hospitalisation among patients aged 65 years and older discharged with a diagnosis of HF were collected. Crude and age-standardised annual incidence rate were reckoned. To analyse HF trend, the age/sex-adjusted average annual change in incidence (incidence rate ratio, IRR) was calculated.


we identified 100,110 HF in the period, with an increase of 16.9% (women 13.4%; men 28.4%). Trochanteric fractures were the most frequent (55.8%). The crude incidence rate (per 100,000 population) decreased from 677.2 (95% confidence interval (95% CI) 662.0-692.7) to 657.6 (95% CI 644.0-671.5). The standardised incidence rate decreased from 754.0 (95% CI 738.6-769.3) to 641.5 (95% CI 627.7-655.3), with a sharp decrease in women (-16.8%) while it was stable in men. The incidence by type of fracture was stable. The trend throughout the period showed a slight decrease with IRR 0.99 (95% CI 0.98-0.99; P = 0.025). The incidence was stable in the oldest group (+85 years), while there was a downward trend in the younger groups. A significant seasonal pattern was observed, with more cases in winter and less in summer (spring as reference).


the secular trend reveals a decreasing incidence of HF although the absolute number has increased in the last 12 years in Catalonia. Trochanteric fractures were the most prevalent and a seasonal pattern was observed, with more cases in winter.


epidemiology; hip fracture; incidence rate ratio; older people; seasonal presentation; secular trend

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