© 1998 Oxford University Press
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Incidence of hip fracture in Kuwait
aDepartment of Community Medicine & Behavioural Sciences, Faculty of Medicine. Kuwait University PO Box 24923, Safat 13110, Kuwait
bAl-Red Orthopsedic Hospital Kuwait
BACKGROUND: Hip fracture as a consequence of osteoporosis is an important cause of morbidity and mortality among the elderly. Due to improving life expectancy, the number of elderly individuals is increasing more rapidly in the developing countries of Asia, the Middle East, Africa, and South America. Incidence of hip fracture, which rises exponentially with age, varies substantially between countries and according to the age, sex, and ethnic distribution of the population. Highest rates are observed in Scandinavia and in whites in the US, intermediate in western Europe, and the lowest rates in Asia. Little is known about the epidemiology of hip fractures in the Middle Eastern populations. In particular, there are no published reports from any of the Arab countries. We have therefore estimated the incidence of hip fracture in Kuwait and compared it with other populations.
METHODS: The study was conducted at a specialized orthopaedic hospital which provides services to residents in the three govemorates—representing about 70% of the total population of Kuwait. All new hip fracture patients who were operated on or treated conservatively during the 4-year period (1992–1995) were induded in the study. Hip fracture was defined as clinical and radiological evidence of frac ture of the proximal femur. For comparison with other populations, age-specific incidence rates in females and males aged 
50 years were standardized to the 1985 US population.
RESULTS: A total of 513 cases of hip fracture (205 females, 308 males) were recorded during the study period: 293 (57.1%) cases occurred among Kuwaiti nationals and 220 (42.9%) among non-Kuwaitis (expatriates). Age-standardized rates (per 100 000) of hip fractures were, in Kuwaitis, 295 for females (95% CI: 238.8–350.8) and 200 for males (95% CI: 163.3–236.5)—much higher than those observed in other Asian countries such as Korea, Singapore, China, Malaysia, and Japan (41–202 for females, 49–100 for males). Rates in Kuwaiti females were similar to those observed in some of the European countries (Italy, UK, France) and in Asian females in the US. In contrast, rates in Kuwaiti males, which were relatively high, were almost equal to those observed in white males in the US. Rates of hip fracture in non-Kuwaitis (374 for females [95% CI: 247.6–500.8], 215 for males [95% CI: 126.5–302.9]), who predominantly (96%) originate from southeast Asian and Arab countries, were similar to those observed in Kuwaiti nationals.
CONCLUSIONS: The incidence of hip fracture in the Kuwaiti population is higher than that reported from other countries in Asia and is comparable to the incidence in some of the western European and North American populations.
Keywords Hip fracture, osteoporosis, incidence, epidemiology, Arab, Middle East, Kuwait
Accepted 5 November 1997
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