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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have carefully read the reflection by Dr&#46; Aguado in a letter to the Editor about the osteoporosis consensus document published by the Spanish Society of Rheumatology&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Without a further assessment on the document itself&#44; we would like to make some comments about an assertion that is made on the incidence of hip fractures in Spain and which we are quoted to determine that &#8220;the incidence of hip fracture has not diminished over the years&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> We appreciate the reading and consideration of our work&#44; but we believe that partial conclusions have been drawn from it&#46; Indeed the incidence of hip fractures in our community&#44; in absolute terms&#44; has increased&#46; However&#44; keep in mind that the life expectancy of the population is increasing and&#44; therefore&#44; the age factor is very important when analyzing certain incidence data&#46; It is necessary to adjust the rates by age&#44; assuming&#44; from a logical perspective&#44; that the older the population&#44; the greater the risk of fracture&#44; since age is a major risk factor in achieving these expectations in the future&#44; the changes in the population pyramid&#44; is precisely the increase in the overall number of cases&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The objective of our work was to establish a relationship between the use of treatment and the incidence of hip fractures&#44; as we had observed that the number of hip fractures was actually increasing&#44; despite the immense economic effort involved with the use of drugs for the management of osteoporosis in our community&#44; a concern also reflected by Dr&#46; Aguado when she points out that we are the country that consumes most of the drugs for this disease&#46; We note that in certain age groups&#44; particularly in the 65&#8211;74 range and those aged between 75 and 84&#44; adjusting rates for age&#44; the incidence of hip fractures decreased between 1994 and 2008&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The results of the Poisson regression are statistically significant for these age groups and not for others&#46; We could not establish a causal relationship with the use of drugs for osteoporosis because it was methodologically wrong&#44; but&#44; given that there has been no change in the population structure or in lifestyle in this period&#44; and assuming that these findings may have diverse origins&#44; we believe it plausible that treatment for osteoporosis has had an influence in reducing the appearance of these fractures&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our results are also consistent with several studies published&#44; reflecting a reversal of the upward trend in the incidence of hip fractures&#44; but considering the analysis of the age factor&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#8211;11</span></a></p></span>"
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Letter to the Editor
Is the Incidence of Hip Fractures Becoming Lower?
Incidencia de fracturas de cadera, ¿se está reduciendo?
Iñigo Etxebarria-Forondaa,
Corresponding author
, Javier Marb
a Servicio de Cirugía Ortopédica y Traumatología, Hospital Alto Deba, Mondragón, Gipuzkoa, Spain
b Unidad de Investigación, Hospital Alto Deba, Mondragón, Gipuzkoa, Spain
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ISSN: 21735743
Original language: English
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