Survival after hip fracture in the elderly population of Croatia

Aims To determine the incidence of hip fracture in elderly people (≥ 65) in Croatia, and to analyse survival by sex, age group, residence and fracture type. Methods To identify individual patients with hip fracture and data on death, we used the Hospital Discharge Database for the period of calendar year 2018 and the Cause of Death Database for the period from 1 January 2018 to 31 December 2020. Incidence of hip fracture was estimated and reported as annual incidence per 100,000 people for 2018, further stratified by age, sex and region of residence. Survival analysis was performed with the Kaplan-Meier method. Survivor function was calculated and presented at various follow-up times. Results 5052 hip fracture cases among the elderly in 2018 were identified. The overall crude incidence of hip fracture in 2018 was 607/100,000 (355/100,000 in males and 778/100,000 in females). Higher incidence was estimated in females across all age groups. Males had a shorter median survival time than females (538 days versus 1036 days). Log-rank test confirmed the significance of difference in survivorship between the sexes, as well as between different age groups and between patients residing in different regions. Survivorship between patients who have suffered different types of femur fracture did not differ significantly. Conclusion Elderly females are more affected by hip fracture in terms of incidence, while men have shorter survival. Results for Croatia are in line with the current knowledge. As hip fracture remains a major public concern, additional efforts need to be put in prevention.