Distal Biceps Tendon Rupture Surgery: Changing Incidence in Finnish and Swedish Men Between 1997 and 2016.

PURPOSE: Distal biceps tendon rupture is a relatively rare injury usually occurring with excess external extension force applied to a flexed elbow. The aim of this study was to examine the incidence of distal biceps tendon rupture surgery in the Finnish and Swedish adult population between the years 1997 and 2016. A secondary aim was to investigate the distal biceps rupture incidence in the Swedish population in 2001 to 2016. METHODS: We assessed the number and rate of distal biceps tendon rupture surgery using the Finnish and Swedish Hospital Discharge Register as databases. The study included the entire Finnish and Swedish adult population aged 18 years and older between January 1, 1997 and of December 31, 2016. RESULTS: During the study period, 2,029 patients had a distal biceps tendon rupture in Finland, and the corresponding figure was 2,000 in Sweden. The rate of distal biceps tendon rupture surgery increased steeply, but equally, in both countries, in Finnish men from 1.3 per 100,000 person-years in 1997 to 9.6 in 2016, and in Swedish men from 0.2 in 1997 to 5.6 in 2016. The incidence of distal biceps tendon rupture in Sweden increased in men from 1.6 to 10.0 per 100,000 person-years from 2001 to 2016. CONCLUSIONS: There was a 7-fold and a 28-fold increase in the incidence of distal biceps tendon rupture surgery in Finnish and Swedish men during 1997 to 2016. The incidence of distal biceps tendon rupture rose 6-fold in Swedish men in 2001 to 2016. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.

Fall-induced wounds and lacerations in older Finns between 1970 and 2014.

BACKGROUND: Fall-induced injuries in elderly people are a growing public health issue. AIM: We aimed to determine the current trends in the fall-induced severe wounds and lacerations among older adults in Finland-an EU country with a well-defined Caucasian population of 5.5 million. METHODS: The injury trends were assessed by taking into account all persons 80 years of age or older who were admitted to Finnish hospitals for primary treatment of these injuries during 1970-2014. RESULTS: The number of fall-induced severe wounds and lacerations among 80-year-old or older Finnish adults showed a sharp increase during the 44-year follow-up, from 52 in 1970 to 1393 in 2014. The age-adjusted incidence of injury (per 100,000 persons) also showed a clear rise from 1970 to 2014: from 98.3 to 511.5 in women, and from 92.0 to 395.3 in men. In both sexes, the increase was greatest in the oldest age group (persons 90 years of age or older). CONCLUSIONS: The number of fall-induced severe wounds and lacerations among older Finnish persons rose in 1970-2014 with a rate that could not be explained merely by demographic changes. Further studies should focus on detailed understanding of the reasons for the rise and assessing possibilities for fall and injury prevention.

Declining incidence in fall-induced deaths of older adults: Finnish statistics during 1971-2015.

BACKGROUND: Fall-induced deaths of elderly people are a major problem. AIM AND METHODS: Using the Official Cause-of-Death Statistics of Finland, we aimed to determine the current trends in the number and age-adjusted incidence (per 100,000 persons) of fall deaths among older Finns by taking into account 50 years or older persons who died because of a fall-induced injury in 1971-2015. RESULTS: Among men, the number of fall-induced deaths increased considerably between 1971 and 2003 (from 162 in 1971 to 564 in 2003), while thereafter, this number has been relatively stable (579 deaths in 2015). Men's age-adjusted incidence of fall deaths rose from 45.6 in 1971 to 69.5 in 1998, after which it stayed relatively stable until 2005 (69.9). Since 2005, this figure has shown a steady, deep decline (only 45.1 in 2015). Among women, the number of fall-induced deaths increased considerably between 1971 and 1998 (from 279 in 1971 to 563 in 1998), while thereafter, this number has been relatively stable (532 deaths in 2015). In sharp contrast to men, women's age-adjusted incidence of fall-induced deaths has been declining since the early 1970s, the incidence being 82.6 in 1971 while only 33.0 in 2015. A steady, deep decline started in 1998. CONCLUSIONS: Among 50 years or older Finns the number of fall-induced deaths increased considerably from the early 1970s until the late 1990s but stabilized thereafter. In the new millennium, the age-adjusted incidence of these deaths has started to decline in both sexes. Despite this we have to effectively continue the falls prevention efforts, because our elderly population will grow rapidly in the near future.

Incidence of distal radius fracture surgery in Finns aged 50 years or more between 1998 and 2016 - too many patients are yet operated on?

BACKGROUND: Although optimal treatment of distal radius fractures is controversial, surgery has gained popularity. The purpose of this study was to evaluate recent trends in the surgical treatment of distal radius fractures in Finns aged 50 years or more. METHODS: A nationwide hospital discharge register-based study was conducted among all patients 50 years of age or older who had a surgically treated distal radius fracture in Finland between 1998 and 2016. The number and rate of different surgical procedures were calculated per 100,000 person-years. RESULTS: Altogether 21,965 surgically treated distal radius fractures were identified. During the study period the rate of percutaneous pinning and external fixation diminished while the rate of plate fixation significantly increased. The rate of operative treatment increased continually from 1998 to 2008 whereupon the peak of the incidence was achieved. After 2008, the rate of operative treatment of distal radius fracture remained quite constant, ranging between 61.1 and 67.8 per 100,000 person-years. CONCLUSIONS: Plate fixation has almost completely replaced both external fixation and percutaneous pinning in the surgical treatment of distal radius fractures in Finland. Despite growing evidence for less invasive treatment options in elderly patients, operative treatment of distal radius fracture is still rather popular today.

Continuous decline in incidence of distal humeral fracture of older women in Finland.

BACKGROUND: Low-trauma fractures (also called osteoporotic fragility fractures or fall-induced fractures) of older adults are a serious public health problem. However, very little population-based information is available on the nationwide numbers, incidences, and especially secular trends of elderly people's low-trauma fractures of the distal humerus. METHODS: We assessed the current trends in the number and incidence of these fractures in 60-year-old or older women in Finland by taking into account all women who were admitted to Finnish hospitals for primary treatment of such fracture in 1970-2014. RESULTS: The annual number of low-trauma distal humeral fractures among Finnish women 60 years of age or older rose over fivefold between 1970 and 1998 (from 42 to 224 fractures), but thereafter, the number decreased down to 198 fractures in 2014. The age-adjusted incidence (per 100,000 persons) of these fractures also increased in 1970-1998 (from 12 to 35) but decreased thereafter to 23 in 2014. The finding was similar in the age-specific patient groups (60-69, 70-79, and 80+): The incidence rose from 1970 till 1998 and decreased thereafter. CONCLUSIONS: The steep rise in the rate of low-trauma distal humeral fractures in 60-year-old or older Finnish women from 1970 till late 1990s has been followed by a clearly declining fracture rate. The exact reasons for this secular change are unknown, but a cohort effect toward improved functional ability among elderly women, as well as measures to prevent falls and alleviate fall severity, could partly explain the phenomenon.

Injury deaths in the adolescent population of Finland: a 43-year secular trend analysis between 1971 and 2013.

BACKGROUND: Injuries are a major public health problem worldwide, being the leading cause of death in children and adolescents in developed countries. However, knowledge on recent secular trends in injury deaths of adolescents is sparse. METHODS: Using Official Cause-of-Death Statistics of Finland, we examined the nationwide trends in the age- and sex-specific incidence rates of fatal injuries among 10-14-year-old and 15-19-year-old adolescents in Finland between 1971 and 2013. RESULTS: The incidence rate of fatal injuries decreased considerably in both age groups during the 43-year follow-up period. The decline in injury deaths was mainly due to decreased deaths in traffic accidents. The number of drownings reached the ultimate goal-that is, there were no drownings in Finnish 10-19-year-old adolescents in 2013. The rates of intentional injury deaths remained stable in girls, while in 15-19-year-old boys a decreasing trend was evident. During the deep economic depression in 1990, the incidence of suicide in 15-19-year-old boys was as high as 40.1. At that time, boys' suicide risk was 7.4 times higher than that of girls. Since then, boys' risk for suicide has clearly decreased and was 1.6 times higher than the corresponding risk in girls in 2013. CONCLUSIONS: The incidence rate of fatal injuries decreased considerably in Finnish adolescents during the period 1971-2013. The clearest change occurred in road traffic injuries and drownings. The rates of intentional injury deaths remained unaltered in girls while 15-19-year-old boys showed a decreasing trend.

Low-trauma knee fractures in older Finnish women between 1970 and 2013.

BACKGROUND: Fresh information on various low-trauma fractures of elderly adults is sparse. AIM: We aimed to assess the current trends in the low-trauma knee fractures among older adults in Finland, an EU country with a well-defined white population of 5.4 million. METHODS: The rates of elderly Finns' low-trauma fractures of the knee (distal femur, patella, and proximal tibia) were assessed by taking into account 60-year-old or older persons who were admitted to Finnish hospitals for primary treatment of such injury in 1970-2013. RESULTS: The incidence of low-trauma knee fractures among 60-year-old or older Finnish women sharply rose between 1970 and 1997, from 55 fractures (per 100,000 persons) in 1970 to 124 fractures in 1997. Thereafter, the incidence continuously declined so that the fracture incidence was 91 in 2013. The corresponding age-adjusted fracture incidences were 60 (1970), 119 (1997), and 83 (2013). In older men, the fracture incidence was rather steady over time: the age-adjusted incidence was 30 in 1970 vs. 28 in 2013. CONCLUSIONS: The rise in the incidence of low-trauma knee fractures in Finnish older women from early 1970s until late 1990s has been followed by a continuous decline in the fracture rate. Reasons for the decline are unknown, but a cohort effect toward a healthier aging female population with improved functionality and decreased risk of injurious slips, trips, and falls could partly explain the observation.

Rising incidence of fall-induced maxillofacial injuries among older adults.

BACKGROUND: Various fall-induced injuries in older adults are a major public health problem. AIM: We aimed to assess the current trends in the fall-induced severe maxillofacial injuries among older adults in Finland, an EU country with a well-defined white population of 5.5 million. METHODS: The injury trends were determined by taking into account all persons 60 years of age or older who were admitted to Finnish hospitals for primary treatment of these injuries between 1999 and 2014. RESULTS: The number of fall-induced maxillofacial injuries among older Finnish adults doubled during the 16-year follow-up, from 434 in 1999 to 981 in 2014. The age-adjusted incidence of injury (per 100 000 persons) also showed a clear increase from 1999 to 2014: from 47.4 to 71.3 in women, and from 39.2 to 59.6 in men. In both sexes, the increase was most prominent in the oldest age group, persons aged 80 years or older. CONCLUSIONS: The number of fall-induced severe maxillofacial injuries among older Finns rose considerably between 1999 and 2014-with a rate that could not be explained merely by demographic changes. Further studies are urgently needed to better assess the reasons for the rise and possibilities for injury prevention.

Fall-induced fractures of the calcaneus and foot in older people: nationwide statistics in Finland between 1970 and 2013 and prediction for the future.

BACKGROUND: Although fall-induced fractures of elderly persons are a major problem, epidemiologic knowledge on their time trends is limited. We assessed the trends in fall-induced fractures of the calcaneus and foot in older Finns between 1970 and 2013. METHODS: The current trends in the number and incidence (per 100,000 persons) of fall-induced fractures of the calcaneus and foot of older Finns were determined by taking into account individuals 50-year-olds or older who were admitted to Finnish hospitals for primary treatment of such injury in 1970-2013. RESULTS: The number and raw incidence of these fractures increased considerably between 1970 and 2013, from 64 (number) and 5.6 (incidence) in 1970, to 325 and 15.0, respectively, in 2013. The age-adjusted incidence of fracture was higher in men than women and showed a clear rise in both sexes in 1970-2013, from 7.2 to 15.2 in men (111% increase), and from 4.3 to 13.9 in women (223% increase). A similar rise was observed in the age-specific incidences. If trends in the age-specific fracture incidence continue at the same rate as were observed in 1970-2013, and the 50-year-old or older population increases as predicted (by 15% by the year 2030), the annual number of fall-induced fractures of the calcaneus and foot in this population will be 1.8 times higher in the year 2030 (580 fractures) than it was in 2013 (325 fractures). CONCLUSIONS: The number of fall-induced fractures of the calcaneus and foot among Finns 50 years of age or older has risen sharply between 1970 and 2013 with a rate that cannot be explained merely by demographic changes. Further studies should examine the reasons for the rise and possibilities for fracture prevention.

Declining incidence of fall-induced ankle fractures in elderly adults: Finnish statistics between 1970 and 2014.

BACKGROUND: Fall-induced fractures of older adults are a major public health concern. However, nationwide information on recent fracture trends is sparse. METHODS: We determined the trend in the number and incidence (per 100,000 persons) of fall-induced ankle fractures among older adults in Finland by taking into account all persons 60 years of age or older who were admitted to Finnish hospitals for primary treatment of such fracture in 1970-2014. RESULTS: The number of fall-induced ankle fractures among 60-year-old or older Finnish persons increased steadily and sharply between 1970 (369 fractures) and 1997 (1668 fractures), but since then, the increase has slowed down (1835 fractures in 2014). The raw incidence of ankle fracture, showing a clear rise from 57 fractures per 100,000 persons in 1970 to 169 fractures in 1997, declined steadily between 1997 and 2014 (to 126 fractures in 2014). Observations on the age-adjusted fracture incidence were similar. During 1970-1997, the age-adjusted incidence of fall-induced ankle fracture clearly rose in both women and men, but thereafter, the incidence declined; in women, from 199 in 1997 to 158 in 2014, and in men, from 123 in 1997 to 80 in 2014. CONCLUSIONS: The sharp rise in the incidence of fall-induced ankle fracture in Finnish older adults from early 1970s until late 1990s has been followed by a declining fracture rate. Despite this welcome development, the rapid aging of our population is likely to increase the absolute number of these fractures in the near future, and therefore, large-scale fracture-preventing intervention studies are urgently needed.

Low-Trauma Pelvic Fractures in Elderly Finns in 1970-2013.

Low-trauma fractures of elderly persons are a major public health problem. However, epidemiologic knowledge on their fresh secular trends is scarce. Trends in the number and incidence (per 100,000 persons) of low-trauma fractures of the pelvic ring among older Finns were assessed by taking into account individuals 80-year-old or older who were admitted to Finnish hospitals for primary treatment of such injury in 1970-2013. The number and age-adjusted incidence of these fractures increased considerably between 1970 and 2013, from 33 (number) and 73 (incidence) in 1970 to 1055 and 364 in 2013. The age-specific incidence of fracture also increased in all age groups (80-84, 85-89, and 90-) of women and men during the entire study period. If the fracture incidence continues to rise at the same rates as in 1970-2013 and the size of the 80-year-old or older population of Finland increases as predicted (87 % by the year 2030), the number low-trauma pelvic fractures in this population will be 2.4 times higher in the year 2030 (2550 fractures) than it was in 2013 (1055 fractures). The number of low-trauma fractures of the pelvis among Finns 80 years of age or older has risen sharply between 1970 and 2013-with a rate that cannot be explained merely by demographic changes. Further studies are urgently needed to better assess the reasons for the rise and possibilities for fracture prevention.

Rapid increase in fall-induced cervical spine injuries among older Finnish adults between 1970 and 2011.

BACKGROUND: fall-related injuries in older adults are a major public heath challenge. METHODS: we determined the current trends in the number and age-adjusted incidence of fall-induced severe cervical spine injuries among older adults in Finland by taking into account all persons in 50 years of age or older who were admitted to Finnish hospitals for primary treatment of these injuries between 1970 and 2011. Similar patients aged 20-49 years served as a reference group. RESULTS: the number of fall-induced cervical spine injuries among older Finns rose six-fold from 59 in 1970 to 372 in 2011. The age-adjusted incidence of injury (per 100 000 persons) was higher in men than in women throughout this period and showed a clear increase from 1970 to 2011: from 8.5 to 20.3 in men, and from 2.8 to 11.7 in women. In both sexes, the increase was most prominent in the oldest age group, persons aged 70 years or older. In the reference group, the injury incidence did not rise by time. CONCLUSIONS: the number and incidence of fall-induced severe cervical spine injuries among older Finns increased considerably between 1970 and 2011. An increase in the average risk of serious falls may partly explain the phenomenon. Wide-scale fall and injury prevention measures are urgently needed, because further ageing of the population is likely to worsen the problem in the near future.

Surgical procedures in femoral neck fractures in Finland: a nationwide study between 1998 and 2011.

PURPOSE: For femoral neck fractures, recent scientific evidence supports cemented hemiarthroplasty (HA) over uncemented HA and suggests that total hip arthroplasty (THA) should be performed more frequently. We report the current surgical trends in treating femoral neck fractures in Finland. METHODS: The study was conducted using the Finnish National Hospital Discharge Register and included all Finns at least 50 years of age who underwent surgery for femoral neck fractures from 1998 through 2011. Age- and sex-specific incidence rates and annual proportion of each treatment method were calculated. RESULTS: During 1998-2011, a total of 49,514 operations for femoral neck fracture were performed in Finland. The proportion of uncemented HA increased from 8.1% in 2005 to 22.2% in 2011. During the same time, the proportion of cemented HA decreased from 63.9 to 52.5%, internal fixation decreased from 23.2 to 16.1% and THA increased from 4.9 to 9.2%. CONCLUSIONS: Between 2005 and 2011, the proportion of uncemented HA for femoral neck fractures increased markedly in Finland, while cemented HA and internal fixation declined. During this time, the use of THA nearly doubled. The current evidence-based guidelines for treatment of femoral neck fractures were mainly followed, but the increase in uncemented HA procedures contradicts recent scientific evidence.

Fatal childhood injuries in Finland, 1971-2010.

BACKGROUND: Childhood injuries are a major public health problem worldwide, injuries being the leading cause of death and disability from early childhood through adolescence. OBJECTIVE: To examine the 40-year nationwide trends in the number and incidence of fatal injuries among children aged 0-14 years in Finland, a country with a white European population of 5.3 million. METHODS: Data were obtained from the Official Cause-of-Death Statistics of Finland during 1971-2010. The main categories for unintentional injury deaths were road traffic injury, water traffic injury, falls, drowning and poisoning. For intentional injury deaths, the main categories were suicide and homicide. RESULTS: In 1971, there were 109 fatal injuries involving girls and 207 involving boys, and in 2010, these numbers were 10 and 16. The corresponding incidence rates (per 100 000 children per year) were 20.1 and 2.3 (girls), and 36.7 and 3.5 (boys). The reduction in fatal injuries was mostly due to fewer unintentional injuries. The greatest decline occurred in the number of fatal motor vehicle injuries: from 57 (girls) and 92 (boys) in 1971 to 5 (girls) and 2 (boys) in 2010. Drownings followed a similar pattern. Violence-related deaths also showed a decreasing trend. In 1971, there were 14 intentional deaths in girls and 15 in boys, while in 2010 these numbers were 0 and 3, respectively. CONCLUSIONS: This nationwide study confirms a decline in childhood injury deaths over the last four decades, with the greatest declines occurring in the number of fatal motor vehicle injuries, drownings and intentional injuries.

Declining age-adjusted incidence of fall-induced injuries among elderly Finns.

BACKGROUND: Elderly people's fall-induced injuries are a major public health challenge. METHODS: We determined the current trends in the number and age-adjusted incidence (per 100,000 persons) of fall-induced injuries among older adults in Finland by taking into account all persons 80 years of age or older who were admitted to Finnish hospitals for primary treatment of a first fall injury over the period 1970-2009. RESULTS: The number of fall-induced injuries in elderly Finns increased considerably during the study period: for women and men separately, these numbers were from 927 to 10,333 (an 11-fold rise), and from 212 to 3,258 (a 15-fold rise), respectively. In both genders, the age-adjusted incidence (per 100,000 persons) of fall-induced injuries increased till the late 1990s but decreased thereafter, the incidence being 2,729 (women) and 1,455 (men) in 1970, and 5,930 (women) and 4,240 (men) in 2009. Even with the current injury incidence the number of these injuries is expected to more than double by the year 2030. CONCLUSION: The rise in the age-adjusted incidence of hospital-treated fall injuries of 80 year old and older Finns from the 1970s to the late 1990s has been followed by declining injury rates. Despite this we have to effectively continue implementation of fall prevention actions.

Significant change in the surgical treatment of distal radius fractures: a nationwide study between 1998 and 2008 in Finland.

BACKGROUND: Studies from the United States report a large increase in the surgical treatment of distal radius fractures with open reduction and internal fixation using locked plates. The aim of the present study was to determine whether the same trend has occurred in a Scandinavian country by assessing the number, incidence, and surgical methods of all surgically treated distal radius fractures in Finland over a recent 11-year period. METHODS: The study covered the whole adult population (aged >19 years) in Finland during the 11-year period from January 1, 1998, to December 31, 2008. Data on surgically treated distal radius fractures were obtained from the nationwide National Hospital Discharge Registry. RESULTS: During the 11-year study period, a total of 14,514 surgical operations (external fixation, percutaneous pinning, or plating) for adult distal radius fractures were performed in Finland. There was a dramatic shift toward internal fixation with plating; the incidence and number of platings more than doubled between 2006 and 2008. The incidence and number of external fixations decreased correspondingly. Percutaneous pinning was used in 13% of the surgical procedures during the study period. CONCLUSIONS: A striking shift from external fixation to plating in the treatment of distal radius fractures has occurred in Finland over the past few years, despite the fact that the scientific literature does not support plating over external fixation. In addition, the incidence and number of surgeries for distal radius fractures doubled between 1998 and 2008. The reasons for these changes are not known.

Sharp Rise in Fall-Induced Cervical Spine Injuries Among Older Adults Between 1970 and 2017.

BACKGROUND: Fall-induced injuries in older adults are a major public health challenge. METHODS: We determined the current trends in the number and age-adjusted incidence of fall-induced severe cervical spine injuries among older adults in Finland by taking into account all persons 50 years of age or older who were admitted to Finnish hospitals for primary treatment of these injuries between 1970 and 2017. Similar patients aged 20-49 years served as a reference group. RESULTS: The annual number of fall-induced severe cervical spine injuries among older Finnish adults rose steeply during the follow-up, from 59 in 1970 to 502 in 2017. The age-adjusted incidence of injury (per 100,000 persons) was higher in men than women throughout this period and showed a clear increase from 1970 to 2017: from 8.4 to 25.0 in men, and from 2.8 to 13.9 in women. In both sexes, the increase was most prominent in the oldest age group, persons aged 80 years or older. In the reference group, the injury incidence declined by time. CONCLUSIONS: The number and incidence of fall-induced severe cervical spine injuries among older Finns showed a sharp rise between 1970 and 2017. An increase in the average risk of serious falls may partly explain the phenomenon. Effective fall and injury prevention measures are urgently needed since further aging of the population is likely to aggravate the problem in the near future.

Fatal childhood injuries in Finland between 1971 and 2017.

BACKGROUND: The injury mortality rates around the globe show considerable country-to-country differences and the rates have decreased at very different speeds. In Finland, the proportion of total mortality attributed to injuries has been one of the highest in the European Union. The purpose of the present study was to examine the 47-year nationwide trend and the male to female ratio in the number and incidence of fatal injuries among 0 to 14-year-old children in Finland. METHODS: The data were obtained from the Official Cause-of-Death Statistics of Finland during 1971-2017. The main categories for unintentional injury deaths were road traffic injuries, water traffic injuries, falls, drownings, and poisonings. For intentional injury deaths, the main categories were suicides and homicides. RESULTS: In 1971, there were 109 fatal injuries in girls and 207 in boys, while in 2017, these numbers had reduced to 9 and 12. The corresponding incidences (per 100,000 children per year) were 20.1 and 2.1 for girls, and 36.7 and 2.6 for boys, respectively. During the study period overall male to female injury incidence ratio decreased from 1.8 to 1.2. The greatest decline occurred in the number of fatal motor vehicle injuries. In 1971, the incidence of intentional deaths (suicides and homicides) was 2.6 in girls and 2.7 in boys, while in 2017 these numbers were 0.9 and 0.4, respectively. CONCLUSIONS: This nationwide study confirms that the number and incidence rates of childhood injury deaths have reduced till current days and are already below the average in Europe.

Fall-induced hospital-treated traumatic brain injuries among elderly Finns in 1970-2017.

BACKGROUND: Fall-induced traumatic brain injuries (TBI) of elderly adults are a major public health concern. METHODS: We determined the current trends in the absolute number and incidence (per 100,000 persons) of severe fall-induced TBI among 80-year-old or older Finns by taking into account all persons who were admitted to Finnish hospitals for primary treatment of such injury between 1970 and 2017. RESULTS: The total number of hospitalized older Finns with a fall-induced TBI increased considerably between the years 1970 and 2017, from 60 (women) and 25 (men) in 1970 to 1622 (women) and 991 (men) in 2017. The age-adjusted incidence of TBI (per 100,000 persons) also showed a clear increase from 1970 to 2017: from 167.9 to 800.4 in women (377% increase), and from 176.8 to 927.3 in men (424% increase). If this trend in the age-adjusted incidence of hospital-treated TBI continues, and the size of the 80-year-old or older Finnish population increases as predicted (from 0.29 million in 2017 to 0.49 million in 2030), the number of these severe injuries among 80-year-old or older Finns will be approximately 1.8 times higher in 2030 (4811 injuries) compared with 2613 injuries in 2017. CONCLUSIONS: The number and age-adjusted incidence of fall-induced hospital-treated TBI among elderly Finns increased considerably between 1970 and 2017. Wide-scale fall and injury prevention measures are urgently needed, because further aging of the population is likely to worsen the problem in the near future.

Incidence of Spine Fracture Hospitalization and Surgery in Finland in 1998-2017.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aim of this study was to assess the incidence and trends of the spine fracture hospitalization and surgery in Finland in 1998-2017. SUMMARY OF BACKGROUND DATA: Traumatic spine fractures are rare, yet they are known to cause significant long-term disability and therefore social, functional, and financial burden. The incidence of spine fractures and related mortality has been suggested to have declined during recent years. However, there are no population-based studies investigating the incidence of surgical treatment of spine fractures. METHODS: The data for this study was obtained from the Finnish nationwide National Hospital Discharge Register. The study population covered all patients 20 years of age or over in Finland during a 20-year period from January 1, 1998 to December 31, 2017. RESULTS: A total of 54,612 patients were hospitalized for a spine fracture in Finland in 1998-2017, and 7138 (13%) of the patients underwent surgery. The annual population-based incidence of spine fracture hospitalization increased 57% during the 20-year period, from 57 per 100,000 person-years to 89 per 100,000 person-years. In addition, the incidence of spine fracture surgery increased 65%, from 5.3 per 100,000 person-years to 8.8 per 100,000 person-years. The incidence of cervical spine fracture surgery tripled, and thoracic spine surgery doubled from 1998 to 2017, while incidence of lumbar fracture surgery declined by 13%. Among patients 60 years of age or older, the incidence of cervical spine fracture surgery increased 400%. CONCLUSION: Incidences of cervical, thoracic, and lumbar fracture hospitalizations increased constantly in Finland during 1998-2017. Accordingly, incidence of cervical and thoracic spine fracture surgery increased rapidly, whereas the incidence of lumbar fracture surgery even decreased, during this 20-year period. LEVEL OF EVIDENCE: 3.