Admission rates and in-hospital mortality for hip fractures in England 1998 to 2009: time trends study.

BACKGROUND Fractures of the proximal femur are an important public health concern. The incidence of hip fractures is an index of osteoporosis burden. There have been no recent studies examining national trends in hip fractures in England. METHODS We used national data for 1998-2009 from the English Hospital Episode Statistics database. Patients with an admission for hip fracture (574,482 admissions) were identified. RESULTS Between 1998 and 2009, there was little change in age-standardized hip fracture rates (102.0-101.8 fractures per 100,000 person-years), but age-standardized in-hospital mortality decreased by 16.5% (95% CI (confidence interval): -18.5 to -8.4%) (126.9-106.0 deaths per 1000 hip fracture admissions). The majority of hip fractures and deaths occurred in females and older people. A socioeconomic gradient of 25.9% difference (95% CI: 15.7-36.1%) existed for mortality in 2008 (93.5-117.7 per 1000). CONCLUSIONS Hip fracture rates have not decreased in England since 1998, although inpatient mortality rates have declined. There is a socioeconomic gradient for in-hospital hip fracture deaths.