Trends in Hip Fracture Incidence, Length of Hospital Stay, and 30-Day Mortality in Sweden from 1998-2017: A Nationwide Cohort Study

In this nationwide cohort study, we investigated trends in hip fracture incidence, hospital length of stay (LOS), and 30-day mortality after admission in Sweden. The cohort included all individuals in Sweden aged >= 50 years with a first hip fracture diagnosis during 1998-2017 (N = 313,761). The outcomes were hip fracture incidence and 30-day mortality. The results showed that the incidence of hip fracture decreased from 79.2 to 46.7/10,000 population in women and from 35.7 to 26.5/10,000 population in men. In contrast, 30-day mortality increased from 4.3% to 6.2% in women (P < 0.001) and from 8.4% to 11.1% in men (P < 0.001). Strong risk factors (P < 1 x 10(-25) for all) for 30-day mortality were older age, male sex, and shorter LOS. From 1998 to 2017, LOS decreased by on average 4 days and was shorter in both male and female aged >= 90 years compared to those aged 80-89 (P < 0.001 for comparisons). In conclusion, despite population aging, hip fracture incidence in Sweden has decreased over the last 20 years. However, short-term mortality has increased, which to some extent may partly be explained by the fact that LOS has decreased without being adapted to important risk factors.

Automated summary

This nationwide cohort study investigated trends in hip fracture incidence, hospital length of stay, and 30-day mortality after admission in Sweden. The results showed a decrease in hip fracture incidence over the past 20 years, but an increase in short-term mortality.