Abstract
Summary
We identified hospitalizations throughout Canada during 2000–2005 in which the most responsible diagnosis was a proximal femoral fracture. Use of the US fracture risk assessment tool (FRAX) would be inappropriate for Canada as it would overestimate fracture risk in Canadian women and older men.
Introduction
It is recommended that the WHO fracture risk assessment tool should be calibrated to the target population.
Methods
We identified hospitalizations for women and men throughout Canada during the study period 2000–2005 in which the most responsible diagnosis was a proximal femoral fracture (147,982 hip fractures). Age-standardized hip fracture rates were compared between Canadian provinces, and national rates were compared with those reported for the USA and Germany.
Results
There were relatively small differences in hip fracture rates between provinces, and most did not differ appreciably from the Canadian average. Hip fracture rates for women in Canada in 2001 were substantially lower than in the USA (population-weighted rate ratio 0.70) and were also lower than in Germany for 2004 (population-weighted rate ratio 0.74).
Conclusions
Overall hip fracture rates for Canadian women were found to be substantially lower than those for the USA and Germany. This study underscores the importance of assessing country-specific fracture patterns prior to adopting an existing FRAX tool.
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Acknowledgments
The analyses and conclusions in this report reflect the opinions of individual experts and not their affiliated organizations.
Conflicts of interest
William D. Leslie: honoraria for lectures from Merck Frosst Canada and unrestricted educational and research grants from Merck Frosst Canada, Sanofi-Aventis, Procter & Gamble Pharmaceuticals Canada, Inc., Novartis Pharmaceuticals Canada, Inc., Amgen Canada, and Genzyme Canada Ltd.
Kerry Siminoski: honoraria for lectures in the past year from Procter and Gamble Pharmaceuticals and Sanofi-Aventis and research support from Merck Frosst, Procter & Gamble Pharmaceuticals, and Sanofi-Aventis.
Stephanie Kaiser: honoraria in the past year from Sanofi-Aventis, Procter & Gamble, Servier Canada, Novartis Pharmaceuticals Canada, Inc., Amgen Canada, Eli Lilly Canada, and Astra Zeneca Canada and unrestricted educational and research grants from Sanofi-Aventis, Procter & Gamble, Novartis Pharmaceuticals Canada, Inc., and Servier Canada.
David L. Kendler: Speakers Bureau, educational grants, advisory boards, and/or research grants from Merck Frosst, Sanofi-Aventis, Procter & Gamble Pharmaceuticals Canada, Inc., Novartis Pharmaceuticals Canada, Inc., Amgen Canada, Eli Lilly Canada Ltd., Nycomed Canada Ltd., Pfizer Canada Ltd., Servier Canada Ltd., GSK Canada Ltd., Biosante Ltd, J and J Canada Ltd., and Zelos Canada Ltd.
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Osteoporosis Surveillance Expert Working Group: Jacques Brown, Laval University, Quebec City, Canada; Ann Cranney, University of Ottawa, Ottawa, Canada; David Hanley, University of Calgary, Calgary, Canada; Susan Jaglal, University of Toronto, Toronto, Canada; Sonia Jean, Institut National de Santé Publique du Québec, Quebec City, Canada; Famida Jiwa, Osteoporosis Canada, Toronto, Canada; Stephanie Kaiser, Dalhousie University, Halifax, Canada; David L. Kendler, Prohealth Clinical Research Centre, Vancouver, Canada; William D. Leslie, University of Manitoba, Winnipeg, Canada; Suzanne Morin, McGill University, Montreal, Canada; Alexandra Papaioannou, McMaster University, Hamilton, Canada; Kerry Siminoski, University of Alberta, Edmonton, Canada
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Leslie, W.D., O’Donnell, S., Lagacé, C. et al. Population-based Canadian hip fracture rates with international comparisons. Osteoporos Int 21, 1317–1322 (2010). https://doi.org/10.1007/s00198-009-1080-1
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DOI: https://doi.org/10.1007/s00198-009-1080-1