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• Half of all hip fractures will occur in Asia by 2050. • This meta-analysis found in-hospital and 30-day mortality rates in Asian countries, notably Japan and Singapore are up to four-fold lower than for Australia and New Zealand. • This difference, although less marked, is sustained at 1-year with a two-fold lower mortality rate in Asia compared to Oceania. : To determine country/region-specific mortality (in-hospital, 30-day and 1-year) following hip fracture across the Asia Pacific region. : Five databases MEDLINE, PUBMED, EMBASE, Web of Science and the Cochrane Library were searched to identify studies that reported mortality following hospitalisation for low-trauma hip fracture in adults aged ≥50 years with data from 2010 to 30 September 2021. There were no restrictions on study design or language. Pooled mortality estimates for countries/regions with ≥2 studies were calculated using random-effects models. : In total 244 studies were included in the meta-analysis. 123 studies (1,382,810 patients, 13 countries/regions) reported in-hospital mortality which ranged from 1.4 % in Japan [95 %CI 1.2–1.7], Singapore [95 %CI 1.0–1.6], China [95 %CI 0.8–2.3] and Hong Kong SAR [95 %CI 0.8–2.6] to 5.5 % [95 %CI 4.1–7.2] in New Zealand. 92 studies (628,450 patients, 13 countries/regions) reported 30-day mortality which ranged from 1.2 % in Japan [95 %CI 0.9–1.5] and Thailand [95 %CI 0.7–2.0] to 7.4 % [95 %CI 7.0–7.8] in Australia. 142 studies (1,139,752 patients, 14 countries/regions) reported 1-year mortality which ranged from 10.8 % [95 %CI 9.6–12.1] in Singapore to 23.3 % [95 %CI 22.3–24.5] in Australia and 23.8 % in New Zealand. : There is substantial variation in mortality across the Asia Pacific region. Short-term mortality rates in Asian countries, notably Japan and Singapore, are up to four-fold lower than for Australia and New Zealand. This difference, although less marked, is sustained at 1-year with a two-fold lower mortality rate in Asia. This meta-analysis is the first to delineate these differences, further studies are required to understand the reasons for this variation. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review aimed to update fragility hip fracture incidences in the Asia Pacific, and compare rates between countries/regions., Method: A systematic search was conducted in four electronic databases. Studies reporting data between 2010 and 2023 on the geographical incidences of hip fractures in individuals aged ≥50 were included. Exclusion criteria were studies reporting solely on high-trauma, atypical, or periprosthetic fractures. We calculated the crude incidence, age- and sex-standardised incidence, and the female-to-male ratio. The systematic review was registered with PROSPERO (CRD42020162518)., Results: Thirty-eight studies were included across nine countries/regions (out of 41 countries/regions). The crude hip fracture incidence ranged from 89 to 341 per 100,000 people aged ≥50, with the highest observed in Australia, Taiwan, and Japan. Age- and sex-standardised rates ranged between 90 and 318 per 100,000 population and were highest in Korea and Japan. Temporal decreases in standardised rates were observed in Korea, China, and Japan. The female-to-male ratio was highest in Japan and lowest in China., Conclusion: Fragility hip fracture incidence varied substantially within the Asia-Pacific region. This observation may reflect actual incidence differences or stem from varying research methods and healthcare recording systems. Future research should use consistent measurement approaches to enhance international comparisons and service planning., Competing Interests: Declaration of competing interest The study was supported by funding from the Asia Pacific Fragility Fracture Alliance (APFFA). The APFFA had no role in the data collection, data analysis, interpretation or writing of this review. The authors have no conflict of interest to declare., (Copyright © 2024. Published by Elsevier B.V.)