Post-pandemic acceleration in osteoporotic hip fracture burden in Ecuador: a joinpoint analysis of Global Burden of Disease data, 2010-2023.

UNLABELLED: Hip fracture burden in Ecuador is poorly characterized. Using Global Burden of Disease estimates (2010-2023), we show increasing incidence and prevalence with a sex-specific divergence in disability: women experienced rising YLDs, whereas male disability remained stable. These findings highlight unmet needs for targeted fracture prevention and post-fracture care.

BACKGROUND

In aging populations, hip fractures are major factors in disability and healthcare costs. However, evidence from Latin America remains limited, especially regarding long-term trends and gender-specific patterns.

METHODS

Between 2010 and 2023 we used estimates from the Global Burden of Disease (GBD) 2021 study to conduct a population-based analysis of the incidence, prevalence, and years of disability due to hip fracture (YLDs) in Ecuador. Age-standardized rates (ASRs) per 100,000 population were calculated for adults aged ≥ 50 years. Joinpoint regression was used to assess temporal trends in order to estimate the annual percentage change (APC) and average annual percentage change (AAPC), overall and by sex.

RESULTS

Age-standardized incidence and prevalence rates of hip fractures increased steadily in Ecuador between 2010 and 2023, while YLDs rates remained relatively stable overall. The incidence increased from 111.8 to 138.1 per 100,000 in both sexes, while YLDs changed marginally (32.6-33.2). Marked differences were observed between the sexes: women showed substantial increases in incidence, prevalence, and YLDs, while the incidence increased modestly and YLDs decreased in men. Between 2020 and 2023, incidence accelerated in both sexes (APC 2%, p < 0.05), exceeding the annual percent change observed in the preceding period.

CONCLUSIONS

There is an increasing burden of hip fractures in Ecuador, driven mainly by women, with a clear disconnect between incidence and disability. These findings contrast with the declining trends reported in several high-income countries. They also highlight unmet needs in osteoporosis prevention and postfracture care in Ecuador.