A RAINBOW OF HOPE BUT STILL A LINGERING CLOUD: OSTEOPOROTIC HIP FRACTURE HOSPITALIZATION PREVALENCE HAS DECLINED AMONG ALL RACIAL/GENDER GROUPS IN THE USA BUT SHOULD WE BE WORRIED ABOUT WHITE MEN?

Background: Osteoporotic hip fracture hospitalizations are a major cause of morbidity and mortality in the elderly. Our previous work has shown a significant drop in hip fracture prevalence in the United States (US) from 1988 to 2005 . Since health care disparities have been documented in minority populations , we explored if such a decline in fractures was widespread among different racial, ethnic and gender groups. Objectives: To study the decrease in osteoporotic hip fracture hospitalization prevalence in Whites, African-American, and Hispanic populations of the US from 1998 to 2008 Methods: Patients older than 55 years, admitted with primary diagnosis of hip fracture were examined in the Nationwide Inpatient sample (NIS) from 1998 to 2008.The NIS is a stratified random sample of all US community hospitals. The 12 states in the NIS database that contained race and ethnicity information in 1998-2008 were studied. Population data was obtained from the US Census Bureau. Results: In 1998, in the US, there were 292,562 total osteoporotic hip fracture hospitalizations in 55 years and over. In the 12 states studied, there were 191,024 hospitalizations, with a prevalence of 750 per 100,000 people. By 2008, the number of hip fracture hospitalizations had declined to 130,599 with a prevalence of 414 per 100,000 people. As seen in the table, hip fracture prevalence in every racial and ethnic group declined from 1998-2008. However, there are noticeable differences between the prevalence of hip fractures in the white population and those in other racial groups. In spite of significant declines, white women have significantly higher prevalence rates both in 1998 and 2008 than any other race (p<0.001). White men have much higher prevalence rates compared to African-American and Hispanic men. In fact, even after recent declines, the prevalence of hip fractures in white men is still higher in 2008 than that in both African-American and Hispanic men in 1998 (p<0.001). White men also had the lowest percentage decline in the 10 years, as compared to all other ethnicities, races and gender (p<0.001). Race and genderPrevalence/Prevalence/% Decline inp-value 100,000 in 1998100,000 in 2008prevalence White Female111664242%p<.001 Black Female35418747%p<.001 Hispanic Female51025051%p<.001 White Male44127837%p<.001 Black Male22511151%p<.001 Hispanic Male22812446%p<.001 Conclusions: Prevalence of hip fracture hospitalizations in ages 55 and older has decreased in all races. This may be due to better screening, education, and early treatment of osteoporosis. However, osteoporotic hip fractures are still a significant burden in the white population, with the prevalence in white men decreasing the least. Further prevention methods should be taken to decrease the hip fracture prevalence, especially in white men. References: 1. A. Sehgal, S. Vadhavkar, A. Mithal, G. Singh G. Triadafilopoulos. A victory in the war on osteoporosis? Declining prevalence of hospitalizations for non-traumatic hip fractures in the US. Annals of the Rheumatic Disease 2008; 67(Supplement II):55. 2. Schneider EC, Zaslavsky AM, Epstein AM. Racial disparities in the quality of care for enrollees in Medicare managed care. JAMA. 2002;287:1288–1294. Disclosure of Interest: A. Sehgal: None Declared, A. Mannalithara Employee of: Stanford, A. Mithal: None Declared, G. Singh: None Declared, G. Triadafilopoulos: None DeclaredCitation: Annals of the Rheumatic Diseases, volume 70, supplement 3, year 2011, page 227Session: Osteoporosis (Poster Presentations )