Previous studies estimated the annual number of hip fractures to reach up to Z-VAD-FMK chemical structure 2.6 million to 4.6 million by 2025 and 4.5 million to 6.26 million by 2050 worldwide, with Asia and Latin America exhibiting the greatest increase [21] and [22]. The Taiwanese population increased from 15,927,167 in 1964 to 23,224,912 in 2011, and the proportion of the elderly population aged 65 years or older increased from 3% in 1964 to 10.7% in 2011 [23]. As the elderly population increases rapidly in Taiwan, hip fractures will become an important public health issue. Several studies recently confirmed the association between hip fracture

and mortality [4], [8], [9], [24], [25], [26], [27], [28] and [29], with some exploring Ixazomib this association using nationwide, long-term, follow-up population data from Asia [9], [25], [27] and [28]. However, no population study reported on the excess mortality of hip fractures in Taiwan. Therefore, this study aims to assess the incidence and excess mortality among hip fracture patients through inpatients aged 60 years or older from a nationwide population database in Taiwan. The National Health Insurance (NHI) database covers the period between 1997 to the present, with data provided annually by the Department of Health of Taiwan. The database covers all patients’ medical benefit claims for more than 23 million

Taiwanese residents in 2011, with a coverage rate exceeding 99% of the whole population. The completeness and accuracy of the NHI database is guaranteed by the Department of Health and the NHI Bureau of Taiwan. This study selected subjects aged 60 years or older, who were admitted to hospitals between 1 January 1999 and 31 December 2009. Subjects were identified from the database based on the following criteria: (i) a first discharge diagnosis code of hip fracture (based on International Classification of Disease,

Ninth Revision, Clinical Modification (ICD-9-CM) codes 820, 820.0, 820.00, 820.01, 820.02, 820.09, 820.8, 820.03, 820.2, 820.20, and 820.21) and (ii) medical code with surgery of internal fixation or hemiarthroplasty (based on ICD-9-CM codes 79.15, 79.35, 81.52). The first admission date of hip fracture was defined as the index date. Reverse transcriptase The exclusion criteria were inpatients with pathological fractures (ICD-9-CM codes 733.14 and 733.15), open hip fractures (ICD-9-CM codes 820.1, 820.10, 820.11, 820.12, 820.19, 820.9, 820.13, 820.22, 820.3, 820.30, 820.31, and 820.32), or involved in a major traffic accident. Patients who had operations on the pelvis, femur, and hip regions before the index date were excluded to avoid confounding effects. In total, 143,595 subjects with hip fracture were enrolled in the study and followed up until exiting the NHI program, death, or the end of 2010.