Abstract
Objective
The aim of this study was to quantify the global burden of osteoporotic fracture worldwide.
Methods
The incidence of hip fractures was identified by systematic review and the incidence of osteoporotic fractures was imputed from the incidence of hip fractures in different regions of the world. Excess mortality and disability weights used age- and sex-specific data from Sweden to calculate the Disability Adjusted Life Years (DALYs) lost due to osteoporotic fracture.
Results
In the year 2000 there were an estimated 9.0 million osteoporotic fractures of which 1.6 million were at the hip, 1.7 million at the forearm and 1.4 million were clinical vertebral fractures. The greatest number of osteoporotic fractures occurred in Europe (34.8%). The total DALYs lost was 5.8 million of which 51% were accounted for by fractures that occurred in Europe and the Americas. World-wide, osteoporotic fractures accounted for 0.83% of the global burden of non-communicable disease and was 1.75% of the global burden in Europe. In Europe, osteoporotic fractures accounted for more DALYs lost than common cancers with the exception of lung cancer. For chronic musculo-skeletal disorders the DALYs lost in Europe due to osteoporosis (2.0 million) were less than for osteoarthrosis (3.1 million) but greater than for rheumatoid arthritis (1.0 million).
Conclusion
We conclude that osteoporotic fractures are a significant cause of morbidity and mortality, particularly in the developed countries.
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References
Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289
Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413
Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902
Kanis JA, Johnell O, Oden A, Borgstrom F, Zethraeus N, De Laet C, Jonsson H (2004) Risk and burden of vertebral fractures in Sweden. Osteoporos Int 15a:20–26
Kanis JA, Oden A, Johnell O, Jonsson B, De Laet C, Dawson A (2000) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427
World Health Organization (2004) The world health report: changing history. World Health Organization, Geneva
Murray CJL, Lopez AP (1996a) Global and regional descriptive epidemiology of disability. Incidence, prevalence, health expectancies and years lived with disability. In: Murray CJL, Lopez AD (eds) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge University Press, Cambridge, pp 201–246
World Health Organization (2002) World health report: reducing risk, promoting healthy life. World Health Organization, Geneva
Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Oglesby AK (2002) International variations in hip fracture probabilities; implications for risk assessment. J Bone Miner Res 17:1237–1244
Lau EM, Lee JK, Suriwongpaisal P, Saw SM, Das De S, Khir A, Sambrook P (2001) The incidence of hip fracture in four Asian countries: the Asian Osteoporosis Study (AOS). Osteoporos Int 12:239–243
Zebaze RM, Seeman E (2003) Epidemiology of hip and wrist fractures in Cameroon, Africa. Osteoporos Int 14:301–305
Melton LJ III, Crowson CS, O’Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban and with rural rates and changes in urban rates over time. Osteoporos Int 9:29–37
Singer BR, McLauchlan CJ, Robinson CM, Christie J (1998) Epidemiology of fracture in 1000 adults. The influence of age and gender. J Bone Joint Surg 80B:234–238
Sanders KM, Nicholson GC, Ugoni AM, Pasco JA, Seeman E, Kotowicz MA (1999) Health burden of hip and other fractures in Australia beyond 2000. Projections based on the Geelong Osteoporosis Study. Med J Aust 170:467–470
Lippuner K, von Overbeck J, Perrelet R, Bossard H, Jaeger P (1997) Incidence and direct medical costs of hospitalizations due to osteoporotic fractures in Sweden. Osteoporosis International 7:414–425
Arneson TJ, Melton LJ III, Lewallen DG, O’Fallon WM (1998) Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965–1984. Clinical Orthopaedics 234:188–194
Oden A, Dawson A, Dere W, Johnell O, Jonsson B, Kanis JA (1998) Lifetime risk of hip fractures is underestimated. Osteoporos Int 8:599–603
Kanis JA, Oden A, Johnell O et al (2003) The components of excess mortality after hip fracture. Bone 32:468–473
Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Patterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42
Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004b) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112
World Health Organization (2002b) Global burden of disease. Discussion paper no. 54. WHO Statistical Information System http://www.who.int/whosis/burden/gbd2000docs
Williams A (1999) Calculating the global burden of disease. Time for a strategic reappraisal. Health Econ 8:1–8
Brazier J, Green C, Kanis JA (2002) On behalf of the Committee of Scientific Advisors, International Osteoporosis Foundation. A systematic review of health-state utility values for osteoporosis. Osteoporos Int 13:768–776
Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767
Felsenberg D, Silman AJ, Lunt M, Ambrecht G, Ismail AA, Finn JD, Cockerill WC, Banzer D, Benevolenskaya LI, Bhalla A, Bruges Armas J, Cannata JB, Cooper C, Dequeker J, Eastell R, Ershova O, Felsch B, Gowin W, Havelka S, Hoszowski K, Jajic I, Janot J, Johnell O, Kanis JA, Kragl G, Lopez Vaz A, Lorenc R, Lyritis G, Masaryk P, Matthis C, Miazgowski T, Parisi G, Pols HAP, Poor G, Raspe HH, Reid DM, Reisinger W, Scheidt-Nave C, Stepan J, Todd C, Weber K, Woolf AD, Reeve J, O’Neill TW (2002) Incidence of vertebral fracture in Europe: results from the European Prospective Osteoporosis Study Epos. J Bone Min Res 17:716-724
Johnell O, Gullberg B, Kanis JA (1977) The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 7:138–144
Johnell O, Kanis JA (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(suppl 2):S3–S7
Acknowledgements
We are grateful to Colin Mathers, World Health Organization, Geneva, who helped us with the DISMOD 2 computer programme and reviewed the manuscript. This project was supported by the International Osteoporosis Foundation.
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Johnell, O., Kanis, J.A. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17, 1726–1733 (2006). https://doi.org/10.1007/s00198-006-0172-4
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DOI: https://doi.org/10.1007/s00198-006-0172-4