Email updates

Keep up to date with the latest news and content from BMC Musculoskeletal Disorders and BioMed Central.

Open Access Research article

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

Aina Pagès-Castellà12, Cristina Carbonell-Abella13, Francesc Fina Avilés14, Maite Alzamora124, Jose Miguel Baena-Díez45, Daniel Martínez Laguna1, Xavier Nogués267, Adolfo Díez-Pérez267 and Daniel Prieto-Alhambra12467*

Author Affiliations

1 Institut Català de la Salut, Barcelona, Spain

2 Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain

3 Universitat de Barcelona, Department of Medicine, Barcelona, Spain

4 IDIAP Jordi Gol (Primary Health Care Research Institute), USR Barcelona and USR Metropolitana Nord, Barcelona, Spain

5 Centre de Salut la Marina, Institut Català de la Salut, Barcelona, Spain

6 URFOA, IMIM, Internal Medicine Department, Parc de Salut Mar, Barcelona, Spain

7 RETICEF (Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad), Instituto Carlos III, Barcelona, Spain

For all author emails, please log on.

BMC Musculoskeletal Disorders 2012, 13:79  doi:10.1186/1471-2474-13-79

Published: 28 May 2012



Knowledge on the epidemiology of non-hip fractures in Spain is limited and somewhat outdated.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.


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 ≥50 years, 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.


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.


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.