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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

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

Published: 28 May 2012

Abstract

Background

Knowledge on the epidemiology of non-hip fractures in Spain is limited and somewhat outdated.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

Methods

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.

Results

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.

Conclusions

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.