Online Program

Estimating the global incidence of femur fracture

Monday, November 4, 2013 : 8:30 a.m. - 8:45 a.m.

Kiran Agarwal-Harding, B.S., Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA
John Meara, MD, DMD, MBA, Department of Plastic Surgery, Boston Childrens Hospital, Boston, MA
Lars Hagander, MD, Program in Global Surgery and Social Change, Boston, MA
Background/Purpose: Trauma causes over five million deaths and many more disabilities annually, disproportionately affecting the young and the poor. Femur fractures occur in approximately one in ten road traffic (RT) injuries and can be effectively treated with surgery. Current incidence of femur fracture by country and by age group is unknown and difficult to measure directly, but is critical to designing and evaluating interventions. Methods: We modeled femur fracture incidence from RT collisions using World Bank, World Health Organization (WHO), and Global Burden of Disease (GBD) data for 176 countries. For all countries and age groups, we estimated femur fracture rate using RT death rates, ratios of RT deaths to injuries, and proportions of RT injuries that were femur fractures. Results: We estimated worldwide annual femur fracture incidence between 1.0 and 2.9 million. Most femur fractures occurred between ages 5 and 14 years (29%), 15 and 44 years (34%), and in those older than 60 (21%). Overall, low- and middle-income countries (LMICs) had an average femur fracture rate between 15.5 and 44.8 per 100,000 people, with an odds ratio of 1.90 (95% CI, 1.89–1.92; p <0.001) compared to high-income countries (HICs). Conclusions: Our estimates were comparable to worldwide and country-specific estimates from other publications. The results demonstrated significant worldwide burden and disparities in femur fracture incidence between LMICs and HICs, underscoring the impact of improved treatment access. This methodology can be applied to other diseases for estimation of burden, allowing for better direction of global health efforts.

Learning Areas:

Public health or related research

Learning Objectives:
Discuss the efficacy of this model to estimate incidence Compare the incidence of femur fracture across country income groups and age groups, and discuss the significance of these findings Discuss the ability to apply this mathematical model to other injuries to estimate incidence

Keyword(s): Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical student studying the global epidemiology of orthopedic injuries including femur fracture. I am a Doris Duke Fellow this year, working with the Program in Global Surgery and Social Change.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.