@article {Mazzucchellie000671, author = {Ram{\'o}n Mazzucchelli and Elia P{\'e}rez Fernandez and Natalia Cresp{\'\i}-Villar{\'\i}as and Javier Quir{\'o}s-Donate and Alberto Garc{\'\i}a Vadillo and Mar{\'\i}a Espinosa and Marina Pe{\~n}a and Cristina Mac{\'\i}a-Villa and Jose Luis Morell-Hita and Cristina Martinez-Prada and Virginia Villaverde and Inmaculada Morado Quiroga and Olalla Guz{\'o}n-Illescas and Carmen Barbadillo and Manuel Fern{\'a}ndez Prada and Hilda Godoy and Angela Herranz Varela and Mar{\'\i}a Galindo Izquierdo and Gil Rodriguez Caravaca}, title = {Trends in hip fracture in patients with~rheumatoid arthritis: results from the Spanish National Inpatient Registry over a 17-year period (1999{\textendash}2015). TREND-AR study}, volume = {4}, number = {1}, elocation-id = {e000671}, year = {2018}, doi = {10.1136/rmdopen-2018-000671}, publisher = {BMJ Specialist Journals}, abstract = {Purpose To analyse trends in hip fracture (HF)~rates in patients~with~rheumatoid arthritis (RA) over an extended time period (17 years).Methods This observational retrospective survey was performed by reviewing data from the National Surveillance System for Hospital Data, which includes more than 98\% of Spanish hospitals. All hospitalisations of patients with RA and HF that were reported from 1999 to 2015 were analysed. Codes were selected using the Ninth International Classification of Diseases, Clinical Modification: ICD-9-CM: RA 714.0 to 714.9 and HF 820.0 to 820.3. The crude and age-adjusted incidence rate of HF was calculated by age and sex strata over the last 17 years. General lineal models were used to analyse trends.Results Between 1999 and 2015, 6656 HFs occurred in patients with~RA of all ages (84.25\% women, mean age 77.5 and 15.75\% men, mean age 76.37). The age-adjusted osteoporotic HF rate was 221.85/100 000 RA~persons/~year (women 227.97; men 179.06). The HF incidence rate increased yearly by 3.1\% (95\% CI 2.1 to 4.0) during the 1999{\textendash}2015 period (p\<0.001) and was more pronounced in men (3.5\% (95\% CI~2.1 to 4.9)) than in women (3.1\% (95\% CI~2.3 to 4.1)). The female~to~male ratio decreased from 1.54 in 1999 to 1.14 in 2015. The average length of hospital stays (ALHS)~decreased (p\<0.001) from 16.76 days (SD 15.3) in 1999 to 10.78 days (SD 7.72) in 2015. Age at the~time of hospitalisation increased (p\<0.001) from 75.3 years (SD 9.33) in 1999 to 79.92 years (SD 9.47) in 2015. There was a total of 326 (4.9\%) deaths during admission, 247 (4.4\%) in women and 79 (7.5\%) in men (p\<0.001).Conclusion In Spain, despite the advances that have taken place in controlling disease activity and in treating osteoporosis, the incidence rate of HF increased in both male and female patients with~RA.}, URL = {https://rmdopen.bmj.com/content/4/1/e000671}, eprint = {https://rmdopen.bmj.com/content/4/1/e000671.full.pdf}, journal = {RMD Open} }