Trends in hip fracture rates in Ecuador and projections for the future.

OBJECTIVE To examine recent trends in hip fracture rates in Ecuador and predict the number of hip fractures over the next decades. METHODS The Anuario de Egresos Hospitalarios, the national database of annual hospital discharges, was analyzed to determine the incidence of hip fractures among those 50 years of age and older in 1999-2008. Census estimates of the population were used as the denominator to calculate hip fracture rates per 100,000 persons. Hip fracture rates were then standardized by the direct method. The annual percentage change in hip fracture rates observed in the different age groups over the study period were used to predict the numbers of hip fractures among older adults by the years 2020, 2030, and 2050. RESULTS The number of hip fractures increased from 703 in 1999 to 1 315 in 2008. After controlling for age, hip fracture rates increased by 3.9% annually (95% Confidence Interval, 1.4-6.5), from 46.4/100,000 in 1999 to 62.4/100,000 in 2008. This increase in age-adjusted rates was mainly attributed to an increase in hip fractures among those 80 years of age or older. If the annual percentage change in age-specific rates continues, the total number of hip fractures among older adults in Ecuador will be about 3,909, 8,980, and 47,275 by the years 2020, 2030, and 2050, respectively. CONCLUSIONS Hip fracture rates increased substantially among persons 50 years of age and older in Ecuador during the study period. As the population of Ecuador ages, the number of hip fractures is expected to increase considerably among those 80 years of age and older.