{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:10:29Z","timestamp":1793171429539,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The epidemiological pattern of the hip fracture burden attributable to falls in Central European countries is still insufficiently known. The aim of this study was to assess the regional and national trends of hip fractures due to falls in Central Europe from 1990 to 2019. Materials and Methods: Using the Global Burden of Disease (GBD) 2019 study, this descriptive epidemiological study presents trends in incidence of and Years Lived with Disability (YLDs) from hip fractures due to falls in the region of Central Europe. All estimates (age- and sex-specific rates, and age-standardized rates) were expressed per 100,000. A joinpoint regression analysis was used to assess trends: the average annual percent change (AAPC) with a corresponding 95% confidence interval (95% CI) was calculated. Results: Among all new cases of hip fracture in the population as a whole in Central Europe in 2019, 3.9% in males and 7.0% in females were attributable to falls, while the share of hip fractures due to falls in the population aged 70 and over was 16.9% in males and 20.0% in females. About 400,000 new cases of hip fracture due to falls occurred in the Central European region in 2019 (220,000 among males and 160,000 among females), resulting in 55,000 YLDs (32,000 in females and 22,000 in males). About one-third of all new cases (59,326 in males and 72,790 in females) and YLDs (8585 in males, and 10,622 in females) of hip fractures due to falls were recorded in Poland. From 1990 to 2019, the age-standardized incidence rates of hip fracture due to falls showed a decreasing tendency in females (AAPC = \u22121.1%), and an increasing tendency in males (AAPC = 0.1%). Both in males and females, YLDs rates of hip fracture due to falls in the Central European region decreased (AAPC = \u22121.6% and AAPC = \u22122.4%, respectively). Conclusions: Hip fracture due to falls represents an important health issue in the Central European region, although incidences and YLDs declined in the most recent decades. However, further efforts to reduce the burden of hip fractures attributed to falls are needed.<\/jats:p>","DOI":"10.3390\/medicina59091528","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T10:06:48Z","timestamp":1692871608000},"page":"1528","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Epidemiology of Hip Fractures Due to Falls"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-3264","authenticated-orcid":false,"given":"Irena","family":"Ilic","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Branko","family":"Ristic","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"},{"name":"Department of Traumatology, Clinic for Orthopedics and Traumatology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Stojadinovic","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"},{"name":"Department of Spinal Surgery, Clinic for Orthopedics and Traumatology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3229-4990","authenticated-orcid":false,"given":"Milena","family":"Ilic","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1007\/s001980050144","article-title":"International variation in the incidence of hip fractures: Cross-national project on osteoporosis for the World Health Organization Program for Research on Aging","volume":"9","author":"Schwartz","year":"1999","journal-title":"Osteoporos. Int."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Zhang, C., Feng, J., Wang, S., Gao, P., Xu, L., Zhu, J., Jia, J., Liu, L., Liu, G., and Wang, J. (2020). Incidence of and trends in hip fracture among adults in urban China: A nationwide retrospective cohort study. PLoS Med., 17.","DOI":"10.1371\/journal.pmed.1003180"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2575","DOI":"10.1007\/s00198-011-1596-z","article-title":"Geographic trends in incidence of hip fractures: A comprehensive literature review","volume":"22","author":"Cheng","year":"2011","journal-title":"Osteoporos. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1001\/jama.2009.1462","article-title":"Incidence and mortality of hip fractures in the United States","volume":"302","author":"Brauer","year":"2009","journal-title":"JAMA"},{"key":"ref_5","first-page":"1","article-title":"Hip fracture epidemiological trends, outcomes, and risk factors, 1970\u20132009","volume":"3","author":"Marks","year":"2010","journal-title":"Int. J. Gen. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/PL00004148","article-title":"World-wide projections for hip fracture","volume":"7","author":"Gullberg","year":"1997","journal-title":"Osteoporos. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1007\/s00198-015-3171-5","article-title":"Portuguese Working Group for the Study of the Burden of Hip Fractures in Portugal. The burden of osteoporotic hip fractures in Portugal: Costs, health related quality of life and mortality","volume":"26","author":"Marques","year":"2015","journal-title":"Osteoporos. Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1177\/1403494816674162","article-title":"One-year health and care costs after hip fracture for home-dwelling elderly patients in Norway: Results from the Trondheim Hip Fracture Trial","volume":"44","author":"Hektoen","year":"2016","journal-title":"Scand. J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s00198-018-4800-6","article-title":"Comparison of hospitalised trends, treatment cost and health outcomes of fall-related hip fracture for people aged \u2265\u200965 years living in residential aged care and the community","volume":"30","author":"Mitchell","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ferris, H., Merron, G., and Coughlan, T. (2023). 1 year mortality after hip fracture in an Irish urban trauma centre. BMC Musculoskelet. Disord., 24.","DOI":"10.1186\/s12891-023-06605-5"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e32683","DOI":"10.2196\/32683","article-title":"One-Year Postfracture Mortality Rate in Older Adults With Hip Fractures Relative to Other Lower Extremity Fractures: Retrospective Cohort Study","volume":"5","author":"Golovko","year":"2022","journal-title":"JMIR Aging"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Dyer, S.M., Crotty, M., Fairhall, N., Magaziner, J., Beaupre, L.A., Cameron, I.D., and Sherrington, C. (2016). Fragility Fracture Network (FFN) Rehabilitation Research Special Interest Group. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr., 16.","DOI":"10.1186\/s12877-016-0332-0"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11606-016-3848-2","article-title":"Rates of Recovery to Pre-Fracture Function in Older Persons with Hip Fracture: An Observational Study","volume":"32","author":"Tang","year":"2017","journal-title":"J. Gen. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bahadori, S., Middleton, R.G., and Wainwright, T.W. (2022). Using Gait Analysis to Evaluate Hip Replacement Outcomes-Its Current Use, and Proposed Future Importance: A Narrative Review. Healthcare, 10.","DOI":"10.3390\/healthcare10102018"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Patterson, J.T., Wier, J., Kumaran, P., and Adamczyk, A. (2023). Rising incidence of acute total hip arthroplasty for primary and adjunctive treatment of acetabular fracture in older and middle-aged adults. Eur. J. Orthop. Surg. Traumatol.","DOI":"10.1007\/s00590-023-03653-4"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Salaha, Z.F.M., Ammarullah, M.I., Abdullah, N.N.A.A., Aziz, A.U.A., Gan, H.S., Abdullah, A.H., Abdul Kadir, M.R., and Ramlee, M.H. (2023). Biomechanical Effects of the Porous Structure of Gyroid and Voronoi Hip Implants: A Finite Element Analysis Using an Experimentally Validated Model. Materials, 16.","DOI":"10.3390\/ma16093298"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s00198-023-06774-y","article-title":"Trends in incidence, health care consumption, and costs for proximal femoral fractures in the Netherlands between 2000 and 2019: A nationwide study","volume":"34","author":"Zeelenberg","year":"2023","journal-title":"Osteoporos. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4103\/0019-5413.73656","article-title":"Epidemiology of hip fracture: Worldwide geographic variation","volume":"45","author":"Dhanwal","year":"2011","journal-title":"Indian. J. Orthop."},{"key":"ref_19","unstructured":"WHO (2018). Falls, WHO. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/falls#:~:text=Key%20facts,greatest%20number%20of%20fatal%20falls."},{"key":"ref_20","unstructured":"GBD 2017 Causes of Death Collaborators (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1736\u20131788."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s002239900679","article-title":"Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: A prospective controlled hip fracture study with 206 consecutive patients","volume":"65","author":"Parkkari","year":"1999","journal-title":"Calcif. Tissue Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"i3","DOI":"10.1136\/injuryprev-2019-043286","article-title":"The global burden of falls: Global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017","volume":"26","author":"James","year":"2020","journal-title":"Inj. Prev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1080\/08952841.2015.1019813","article-title":"Fall-related injuries in Amsterdam: Frail older women at risk","volume":"28","author":"Harmsen","year":"2016","journal-title":"J. Women Aging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.puhe.2018.05.002","article-title":"Inequalities in hip fracture incidence are greatest in the North of England: Regional analysis of the effects of social deprivation on hip fracture incidence across England","volume":"162","author":"Bhimjiyani","year":"2018","journal-title":"Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s13690-022-00891-6","article-title":"The burden of injury in Central, Eastern, and Western European sub-region: A systematic analysis from the Global Burden of Disease 2019 Study","volume":"80","author":"Haagsma","year":"2022","journal-title":"Arch. Public Health"},{"key":"ref_26","unstructured":"GBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 396, 1204\u20131222."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1016\/S0140-6736(16)30388-9","article-title":"Guidelines for Accurate and Transparent Health Estimates Reporting: The GATHER statement","volume":"388","author":"Stevens","year":"2016","journal-title":"Lancet"},{"key":"ref_28","unstructured":"United Nations Development Programme (2023, June 05). Human Development Index (HDI). Available online: https:\/\/hdr.undp.org\/."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z","article-title":"Permutation tests for joinpoint regression with applications to cancer rates","volume":"19","author":"Kim","year":"2000","journal-title":"Stat. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2307\/2346413","article-title":"Fitting segmented regression models by grid search","volume":"29","author":"Lerman","year":"1980","journal-title":"Appl. Stat."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3670","DOI":"10.1002\/sim.3733","article-title":"Estimating average annual per cent change in trend analysis","volume":"28","author":"Clegg","year":"2009","journal-title":"Stat. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1111\/j.0006-341X.2004.00256.x","article-title":"Comparability of segmented line regression models","volume":"60","author":"Kim","year":"2004","journal-title":"Biometrics"},{"key":"ref_33","unstructured":"GBD 2019 Fracture Collaborators (2021). Global, regional, and national burden of bone fractures in 204 countries and territories, 1990\u20132019: A systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev., 2, e580\u2013e592."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1007\/s00068-021-01797-8","article-title":"Differences in hip fracture care in Europe: A systematic review of recent annual reports of hip fracture registries","volume":"48","author":"Werner","year":"2022","journal-title":"Eur. J. Trauma. Emerg. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1007\/s00198-021-05910-w","article-title":"Higher latitude and lower solar radiation influence on hip fracture admissions in Chilean older population","volume":"32","year":"2021","journal-title":"Osteoporos. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.maturitas.2015.06.035","article-title":"Falls and Fractures: A systematic approach to screening and prevention","volume":"82","author":"Ambrose","year":"2015","journal-title":"Maturitas"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s11657-019-0594-1","article-title":"The effect of a multidisciplinary co-management program for the older hip fracture patients in Beijing: A \u201cpre- and post-\u201d retrospective study","volume":"14","author":"Wu","year":"2019","journal-title":"Arch. Osteoporos."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1359\/jbmr.090706","article-title":"Prevalence and trends in low femur bone density among older US adults: NHANES 2005\u20132006 compared with NHANES III","volume":"25","author":"Looker","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"57622","DOI":"10.52965\/001c.57622","article-title":"Prevalence of low bone mineral density at axial sites and fracture risk in Bulgarian population","volume":"14","author":"Kirilova","year":"2022","journal-title":"Orthop. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1056\/NEJM199105093241905","article-title":"Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group","volume":"324","author":"Grisso","year":"1991","journal-title":"N. Engl. J. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1007\/s00198-013-2586-0","article-title":"Changing trends in the epidemiology of hip fracture in Spain","volume":"25","author":"Azagra","year":"2014","journal-title":"Osteoporos. Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1006527","DOI":"10.3389\/fpubh.2023.1006527","article-title":"Recent advances in the identification of related factors and preventive strategies of hip fracture","volume":"11","author":"Yu","year":"2023","journal-title":"Front. Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.bone.2015.04.032","article-title":"Declining incidence trends for hip fractures have not been accompanied by improvements in lifetime risk or post-fracture survival\u2014A nationwide study of the Swedish population 60 years and older","volume":"78","author":"Karampampa","year":"2015","journal-title":"Bone"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/9\/1528\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:37:57Z","timestamp":1760128677000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/9\/1528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,24]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["medicina59091528"],"URL":"https:\/\/doi.org\/10.3390\/medicina59091528","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,24]]}}}