The incidence rates and hospital length-of-stay of subtrochanteric fractures have decreased in the 2000–2019 period in the Netherlands.
•Subtrochanteric fracture incidence is higher in women and increases with age.
•Subtrochanteric fractures make up a relatively small portion of total hip fractures with an associated annual cost of €15.5 M.
•Increasing incidence rates and a bimodal age-distribution, described in previous research, were not found in the Dutch population.
AbstractObjectiveThis study aimed to provide population based trends in incidence rate, hospital length of stay (HLOS), trauma mechanism, and costs for healthcare and lost productivity of subtrochanteric femur fractures in the Netherlands.
MethodsData on patients with subtrochanteric femur fractures sustained between January 1, 2000 and December 31, 2019 were extracted from the National Medical Registration of the Dutch Hospital Database. Incidence rates, HLOS, health care and productivity costs were calculated in sex- and age-specific groups.
ResultsA total of 14,399 patients sustained a subtrochanteric fracture in the 20-year study period. Incidence rates in the entire population dropped by 15.5 % from 4.5 to 3.8 per 100,000 person years (py). This decline was larger in women (6.4 to 5.2 per 100,000 py, -19.8 %) than in men (2.6 to 2.5 per 100,000 py, -4.0 %). HLOS declined by 62.5 % from a mean of 21.6 days in 2000–2004 to 8.1 days in 2015–2019. Subtrochanteric fractures were associated with total annual costs of €15.5 M, of which 91 % (€14.1 M) were health care costs and €1.3 M were costs due to lost productivity. Mean healthcare costs per case were lower in men (€16,394) than in women (€23,154).
ConclusionThe incidence rates and HLOS of subtrochanteric fractures in the Netherlands have decreased in the 2000–2019 study period and subtrochanteric fractures are associated with a relatively small total annual cost of €15.5 M. Increasing incidence rates and a bimodal age distribution, described in previous studies from other European countries, were not found in the Dutch population.
KeywordsSubtrochanteric fracture
Incidence
Hlos
Health care costs
Lost productivity
Data availabilityThe data supporting the findings of this study are available on reasonable request from the corresponding author. All data used in figures can be found in Online Resource 1.
© 2024 The Author(s). Published by Elsevier Ltd.
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