Multicenter Epidemiological Analysis of Hip Fractures in Uruguay: Im-portance and Planning of a National Register

Abstract

Introduction: The incidence of hip fractures dramatically increases
from middle age on, posing a prevalent health problem in elderly
1Clínica de Traumatología y Ortopedia del Adulto de la Facultad de Medicina de la Udelar. Correo electrónico: alnamaya@gmail.com, espigamartin@gmail.com, paolafilo-meno@hotmail.com, drrogeliorey@hotmail.com ORCID: 0000-
0001-7896-3921. ORCID: 0000-0001-5964-1927. ORCID: 0000-0003-4664-1527. ORCID: 0000-0001-5736-3601
2Carrera de Doctor en Medicina de la UdelaR (Curso de Metodología Científica II). Correo electrónico: chiarabrunolamorte96@gmail.com, veronicaferdelavega@gmail.com, mazzilli.deneb@gmail.com, reycarolina18@gmail.com,
luciataibo96@gmail.com ORCID: 0000-0002-3229-2816. ORCID: 0000-0002-1268-8063. ORCID: 0000-0002-7591-7935. ORCID: 0000-0002-3330-6677.
3CASMU. Correo electrónico: dobelsanc@gmail.com ORCID: 0000-0001-7165-7489
people. A literature review of the international hip fracture registers,
as well as a multicenter, epidemiological study were carried out in
order to assess the incidence, costs, and mortality of this pathology
in our country.
Material and methods: All international hip fracture registers in
the world were searched, reviewed and analyzed. An observational,
retrospective, multicenter descriptive analysis was then carried out in
4 healthcare centers for patents over 50 years of age who underwent
surgery with osteosynthesis due to hip fracture in 2019. Age, sex, type
of fracture, incidence and costs were assessed from the anonymized
data. Statistical and economic data from the National Resources Fund
Register were also included and associated. The SPSS statistical
software was used to establish univariate, bivariate, and multivariate
associations. The chi squared statistical test was used to compare
proportions.
Results: Review of the registers is summarized in a table. The
multicenter analysis included 646 patients with hip fractures. Worth
of note is the high prevalence of this pathology in patients over 79
years of age (63.1%) and females (77.6%), in line with the international
registers, and a significant association between both variables (p <
0.0001). Unlike other registers, and probably due to inaccurate data,
the most frequent fracture was that of femoral neck (43%). The time
from fracture to surgery and inpatient days were 2.6 and 7.2 days,
respectively, in the most effective health care center. Our calculation
showed a hip fracture incidence in Uruguay between 235 and 391
per 100,000 inhabitants over 50 years of age. The estimated cost of
the assessed series was about U$S 2,855,320, and in general this
pathology generates an annual expense of about U$S 20,000,000
for our country.
Conclusion: Hip fractures have high incidence, costs and mortality
and morbidity in the elderly population comparable with international
data. It is necessary to have a National Hip Fracture Register that
provides accurate statistical data in order to establish adequate
prevention, treatment and cost control policies.