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The relationship of fall-related fractures to social deprivation

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Abstract

Summary

The relationship between fall-related fractures and social deprivation was studied in 3,843 patients. The incidence of fractures correlated with deprivation in all age groups although the spectrum of fractures was not affected by deprivation. The average age and the prevalence of hip fractures decreased with increasing deprivation.

Introduction

This study examines the relationship between social deprivation and fall-related fractures. Social deprivation has been shown to be a predisposing factor in a number of diseases. There is evidence that it is implicated in fractures in children and young adults, but the evidence that it is associated with fragility fractures in older adults is weak. As fragility fractures are becoming progressively more common and increasingly expensive to treat, the association between social deprivation and fractures is important to define.

Methods

All out-patient and in-patient fractures presenting to the Royal Infirmary of Edinburgh over a 1-year period were prospectively recorded. The fractures caused by falls from a standing height were analysed in all patients of at least 15 years of age. Social deprivation was assessed using the Carstairs score and social deprivation deciles, and the 2001 census was used to calculate fracture incidence. The data were used to analyse the relationship between social deprivation and fall-related fractures in all age groups.

Results

The incidence of fall-related fractures correlated with social deprivation in all age groups including fragility fractures in the elderly. The overall spectrum of fractures was not affected by social deprivation although the prevalence of proximal femoral fractures decreased with increasing deprivation. The average age of patients with fall-related fractures also decreased with increasing social deprivation as did the requirement for in-patient treatment.

Conclusions

This is the first study to show the relationship between fall-related fractures and social deprivation in older patients. We believe that the decreased incidence of proximal femoral fractures, and the lower average age of patients with fall-related fractures, in the socially deprived relates to the relative life expectancies in the different deprivation deciles.

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References

  1. Barakat K, Stevenson S, Wilkinson P, Suliman A, Ranjadayalan K, Timmis AD (2000) Socioeconomic differentials in recurrent ischaemia and mortality after acute myocardial infarction. Heart 85:390–394

    Article  Google Scholar 

  2. Hole DJ, McArdle CS (2002) Impact of socioeconomic deprivation on outcome after surgery for colorectal cancer. Br J Surg 89:586–589

    Article  PubMed  CAS  Google Scholar 

  3. Evans JMM, Newton RW, Ruta DA, MacDonald TM, Morris AD (2000) Socio-economic status, obesity and prevalence of type 1 and type 2 diabetes mellitus. Diabet Med 17:478–480

    Article  PubMed  CAS  Google Scholar 

  4. Dunn L, Henry J, Beard D (2003) Social deprivation and adult head injury: a national study. J Neurol Neurosurg Psychiatry 74:1060–1064

    Article  PubMed  CAS  Google Scholar 

  5. Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, Simmons A, Williams G (1998) Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 57:649–655

    Article  PubMed  CAS  Google Scholar 

  6. MacKenzie EJ, Bosse MJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, Sanders RW, Jones AL, McAndrew MP, Patterson TM, McCarthy ML (2000) Characterization of patients with high-energy lower extremity trauma. J Orthop Trauma 7:455–466

    Article  Google Scholar 

  7. Pillai A, Atiya S, Costigan PS (2004) The incidence of Perthes' disease in Southwest Scotland. J Bone Joint Surg Br 87-B:1531–1535

    Google Scholar 

  8. Jenkins PJ, Perry PWR, Ng CW, Ballantyne JA (2009) Deprivation influences the functional outcome from hip arthroplasty. Surgeon 7:351–356

    Article  PubMed  CAS  Google Scholar 

  9. Bridgeman S, Wilson R (2004) Epidemiology of femoral fractures in children in the West Midlands region of England 1991–2001. J Bone Joint Surg Br 86-B:1152–1157

    Article  Google Scholar 

  10. Silversides JA, Gibson A, Glasgow JF, Mercer R, Cran GW (2005) Social deprivation and childhood injuries in North and West Belfast. Ulster Med J 74:22–28

    PubMed  CAS  Google Scholar 

  11. Stark AD, Bennet GC, Stone DH, Chisti P (2002) Association between childhood fractures and poverty: population based study. BMJ 324:457

    Article  PubMed  Google Scholar 

  12. Menon MRG, Walker JL, Court-Brown CM (2008) The epidemiology of fractures in adolescents with reference to social deprivation. J Bone Joint Surg Br 90-B:1482–1486

    Article  Google Scholar 

  13. Mattila VM, Jormanainen V, Sahi T, Pihlajamäki H (2007) An association between socioeconomic, health and health behavioural indicators and fractures in young adult males. Osteoporos Int 18:1609–1615

    Article  PubMed  CAS  Google Scholar 

  14. West J, Hippisley-Cox J, Coupland CA, Price GM, Groom LM, Kendrick D, Webber E (2004) Do rates of hospital admission for falls and hip fracture in elderly people vary by socio-economic status? Public Health 118:576–581

    Article  PubMed  CAS  Google Scholar 

  15. Icks A, Haastert B, Wildner M, Becker C, Rapp K, Dragano N, Meyer G, Rosenbauer J et al (2009) Hip fractures and area level socioeconomic conditions: a population based study. BMC Public Health 9:114

    Article  PubMed  Google Scholar 

  16. Zingmond DS, Soohoo NF, Silverman SL (2006) The role of socioeconomic status on hip fracture. Osteoporos Int 17:1562–1568

    Article  PubMed  CAS  Google Scholar 

  17. Sanders KM, Nicholson GC, Ugoni AM, Seeman E, Pasco JA, Kotowicz MA (2002) Fracture rates lower in rural than urban communities: the Geelong Osteoporosis Study. J Epidemiol Community Health 56:466–470

    Article  PubMed  CAS  Google Scholar 

  18. Jones S, Johansen A, Brennan J, Butler J, Lyons RA (2004) The effect of socioeconomic deprivation on fracture incidence in the United Kingdom. Osteoporos Int 15:520–524

    Article  PubMed  Google Scholar 

  19. Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691–697

    Article  PubMed  Google Scholar 

  20. Court-Brown CM, Brydone A (2007) Social deprivation and adult tibial diaphyseal fractures. Injury 38:750–754

    Article  PubMed  Google Scholar 

  21. Horton TC, Dias JJ, Burke FD (2007) Social deprivation and hand injury. J Hand Surg Eur 26:29–35

    Google Scholar 

  22. Carstairs V, Morris R (1990) Deprivation and health in Scotland. Health Bull 48:162–175

    CAS  Google Scholar 

  23. Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319:1701–1707

    Article  PubMed  CAS  Google Scholar 

  24. Kallin K, Lundin-Olsson L, Jensen J, Nyberg L, Gustafson Y (2002) Predisposing and precipitating factors for falls among older people in residential care. Public Health 116:263–271

    PubMed  CAS  Google Scholar 

  25. Sjögren H, Björnstig U (1989) Unintentional injuries among elderly people: incidence, cause, severity and costs. Accid Anal Prev 21:233–242

    Article  PubMed  Google Scholar 

  26. Scuffham P, Chaplin S, Legood R (2003) Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health 57:740–744

    Article  PubMed  CAS  Google Scholar 

  27. Von Heideken WP, Gustafson Y, Kallin K, Jensen J, Lundin-Olsson (2009) Falls in very old people: the population based Umeå study in Sweden. Arch Gerontol Geriatr 49:390–396

    Article  Google Scholar 

  28. Centres of Disease Control and Prevention. Costs of falls among older adults. Available at: http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html. Accessed 16 Feb 2010

  29. De Laet CE, van Haut BA, Burger H, Hofman A, Pols (1997) Bone density and risk of hip fracture in men and women: cross sectional analysis. BMJ 315:221–225

    PubMed  Google Scholar 

  30. Navarro MC, Sosa M, Saavedra P, Lainez P, Marrero M, Torres M, Medina CD (2009) Poverty is a risk factor for osteoporotic fractures. Osteoporos Int 20:393–398

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

We wish to thank Dr. Robert Elton for his assistance with the statistical analysis of the data in this study. We also wish to acknowledge the help received from The Scottish Orthopaedic Research Trust into Trauma (SORT-IT).

Ethics approval

The requirement for ethics approval for this type of study has been discussed with the local Ethics Committee who agree that this is an audit.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Royal Infirmary of Edinburgh, University of Edinburgh, EH16 4SU, Edinburgh, UK

    C. M. Court-Brown, S. A. Aitken & M. M. McQueen

  2. Institute of Genetics and Molecular Medicine University of Edinburgh Western General Hospital, EH4 2XU, Edinburgh, UK

    S. H. Ralston

Authors
  1. C. M. Court-Brown
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  2. S. A. Aitken
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  3. S. H. Ralston
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  4. M. M. McQueen
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Corresponding author

Correspondence to C. M. Court-Brown.

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Court-Brown, C.M., Aitken, S.A., Ralston, S.H. et al. The relationship of fall-related fractures to social deprivation. Osteoporos Int 22, 1211–1218 (2011). https://doi.org/10.1007/s00198-010-1315-1

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  • DOI: https://doi.org/10.1007/s00198-010-1315-1

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