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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/21629

Title: Epidemiology of fractures in the United Kingdom 1988-2012: Variation with age, sex, geography, ethnicity and socioeconomic status
Authors: Curtis, Elizabeth M.
van der Velde, Robert
Moon, Rebecca J.
van den Bergh, Joop P. W.
Geusens, Piet
de Vries, Frank
van Staa, Tjeerd P.
Cooper, Cyrus
Harvey, Nicholas C.
Issue Date: 2016
Citation: BONE, 87, p. 19-26
Abstract: The Summary: Rates of fracture worldwide are changing. Using the Clinical Practice Research Datalink (CPRD), age, and gender, geographical, ethnic and socioeconomic trends in fracture rates across the United Kingdom were studied over a 24-year period 1988-2012. Previously observed patterns in fracture incidence by age and fracture site were evident. New data on the influence of geographic location, ethnic group and socioeconomic status were obtained. Introduction: With secular changes in age- and sex-specific fracture incidence observed in many populations, and global shifts towards an elderly demography, it is vital for health care planners to have an accurate understanding of fracture incidence nationally. We aimed to present up to date fracture incidence data in the UK, stratified by age, sex, geographic location, ethnicity and socioeconomic status. Methods: The Clinical Practice Research Datalink (CPRD) contains anonymised electronic health records for approximately 6.9% of the UK population. Information comes from General Practitioners, and covers 113 million people from 674 practices across the UK, demonstrated to be representative of the national population. The study population consisted of all permanently registered individuals aged ?:18 years. Validated data on fracture incidence were obtained from their medical records, as was information on socioeconomic deprivation, ethnicity and geographic location. Age- and sex-specific fracture incidence rates were calculated. Results: Fracture incidence rates by age and sex were comparable to those documented in previous studies and demonstrated a bimodal distribution. Substantial geographic heterogeneity in age- and sex adjusted fracture incidence was observed, with rates in Scotland almost 50% greater than those in London and South East England. Lowest rates of fracture were observed in black individuals of both sexes; rates of fragility fracture in white women were 4.7 times greater than in black women. Strong associations between deprivation and fracture risk were observed in hip fracture in men, with a relative risk of 1.3 (95% CI 1.21-1.41) in Index of Multiple Deprivation category 5 (representing the most deprived) compared to category 1. Conclusions: This study presents robust estimates of fracture incidence across the UK, which will aid decisions regarding allocation of healthcare provision to populations of greatest need. It will also assist the implementation and design of strategies to reduce fracture incidence and its personal and financial impact on individuals and health services. (C) 2016 Elsevier Inc. All rights reserved.
Notes: [Curtis, Elizabeth M.; Moon, Rebecca J.; Cooper, Cyrus; Harvey, Nicholas C.] Univ Southampton, MRC Lifecourse Epidemiol Unit, Tremona Rd, Southampton SO16 6YD, Hants, England. [van der Velde, Robert; van den Bergh, Joop P. W.] VieCuri Med Ctr, Dept Internal Med, NL-595971 P Venlo, Netherlands. [Moon, Rebecca J.] Southampton Univ Hosp NHS Fdn Trust, Paediat Endocrinol, Southampton SO16 6YD, Hants, England. [van den Bergh, Joop P. W.] Maastricht Univ, Med Ctr, NL-6200 MD Maastricht, Netherlands. [Geusens, Piet] Maastricht Univ, Med Ctr, Dept Internal Med, Subdiv Rheumatol, NL-6200 MD Maastricht, Netherlands. [Geusens, Piet] Univ Hasselt, Hasselt, Belgium. [de Vries, Frank] Maastricht Univ, Med Ctr, Dept Clin Pharm & Toxicol, NL-6200 MD Maastricht, Netherlands. [de Vries, Frank; van Staa, Tjeerd P.] Univ Utrecht, Dept Pharmacoepidemiol & Clin Pharmacol, NL-3508 TB Utrecht, Netherlands. [van Staa, Tjeerd P.] Univ Manchester, Farr Inst Hlth Informat Res, Hlth ERes Ctr, 1-003 Vaughan House,Portsmouth Rd, Manchester M13 9PL, Lancs, England. [Cooper, Cyrus; Harvey, Nicholas C.] Univ Southampton, NIHR Southampton Biomed Res Ctr, Tremona Rd, Southampton SO16 6YD, Hants, England. [Cooper, Cyrus; Harvey, Nicholas C.] Univ Hosp Southampton NHS Fdn Trust, Tremona Rd, Southampton SO16 6YD, Hants, England. [Cooper, Cyrus] Univ Oxford, Nuffield Orthoped Ctr, NIHR Musculoskeletal Biomed Res Unit, Oxford OX3 7HE, England.
URI: http://hdl.handle.net/1942/21629
DOI: 10.1016/j.bone.2016.03.006
ISI #: 000376055100003
ISSN: 8756-3282
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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