Secular trend of humeral fractures incidence rates in patients ≥ 50 years requiring hospitalization: a retrospective analysis of the public health system data in Brazil from 2004 to 2013.

UNLABELLED: This study examined the incidence trend of humeral fragility fractures among Brazilian adults over age 50 admitted to public hospitals from 2004 to 2013. The findings revealed significant increases in annual rates of humeral fractures, especially among elderly women and patients from the Southeast region. It is essential for the implementation of effective public health policies.

PURPOSE: Humeral fragility fractures are associated with a significant health care burden, especially those requiring surgeries. With limited epidemiological data, the present study aimed to determine the annual rate of humeral fractures requiring hospitalization in the public health system among Brazilian adults ≥ 50 years-old between 2004 and 2013. A secular trend analysis of the humeral fracture rate was also investigated.

METHODS

This was a retrospective, observational study of admissions in the Brazilian public hospitals from 2004 to 2013, including patients 50 years and older admitted for primary treatment with a primary diagnosis of humerus fractures (ICD-10 S-42.2, S-42.3 and S-42.4) associated with low-trauma events. The annual rates of humeral fractures were calculated according to sex, age, and geographic region, and a linear regression analysis was used to determine secular trends.

RESULTS

Most of the total of 34,071 humeral fractures occurred in women (59.21%), among the age group 50-59 years (33.14%) and in residents from the Southeast region (60%). The average annual rate of humeral fractures for the overall population, women and men was 12.56, 14.11 and 10.85 per 100,000 inhabitants-years, respectively. Secular trend analysis showed a 21.18% significant increase in the crude humeral fracture rate among women (P = 0.024). There was a reduction in humeral fracture rate between 2004 and 2008 followed by an increase from 2009 to 2013. The Southeast region had the highest fracture rates with a significant 11.95% increase in secular trend for women (P = 0.031).

CONCLUSION

Hospitalizations for humeral fractures in Brazil increased significantly from 2004 to 2013, particularly among elderly women and those living in the most densely populated Southeast region. As osteoporotic humeral fractures are often associated with an increased risk of subsequent major osteoporotic fractures, especially hip fractures, understanding this trend is essential for implementing effective public health policies.

LEVEL OF EVIDENCE: Level III-Retrospective Design Using a Large Database. Prognosis Study.