Assessing Fracture Risk with DXA: Comparing 2008 to 1998 NOF Guidelines - The Influence of FRAX
| Autor: | Eric D. Newman, Sorina Dancea, Thomas P. Olenginski, William T. Ayoub |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Fracture risk
medicine.medical_specialty Hip fracture FRAX business.industry Endocrinology Diabetes and Metabolism Medical record Osteoporosis medicine.disease medicine.anatomical_structure Cut off point Internal medicine Medicine Radiology Nuclear Medicine and imaging Orthopedics and Sports Medicine business Risk assessment Femoral neck |
| Zdroj: | Journal of Clinical Densitometry. 13:120 |
| ISSN: | 1094-6950 |
| Popis: | Background: FRAX model offers the possibility to use either femoral neck BMD or BMI alone to evaluate fracture risk. Our aim was to evaluate the impact of using femoral neck BMD or BMI only on the fracture risk assessment based on this model. Materials: We use a retrospective analysis of medical records of 280 patients (262 women and 18 men, mean age of 63.4 years) who received treatment in National Program for Osteoporosis in Elias Hospital and C.I. Parhon Institute in Bucharest in 2008. Patients were selected based on the availability of femoral neck BMD and the lack of previous antiosteoporotic treatment. We calculated major osteoporotic fracture risk based on femoral neck BMD respective based on BMI alone for every patient. Same analysis was done for hip fracture risk. For treatment recommendation a cut off point of 20% was used for major osteoporotic fracture and 3% for hip fracture. Results: We found a significantly lower (p ! 0.001) risk fracture when we used BMI alone for both major osteoporotic fracture (mean 9.7 vs. 11.4) and hip fracture (mean 3.6 vs 4.8) risk evaluations. Using BMI alone comparing to femoral neck BMD to calculate major osteoporotic fracture risk, 17 patients (6%) were excluded from treatment recommendation and 2 (0.7%) were included. In the same manner, in the hip fracture risk evaluation, using BMI alone excluded 61 (21.8%) patients from treatment and 8 (2.8%) were included. Conclusion: Use of BMI alone significantly underestimated fracture risk for both major osteoporotic and hip fracture. Treatment recommendation based on hip fracture risk assessment was changed in almost 25% of the patients when using BMI alone, mostly trough exclusion from treatment (21.8%). It suggests that, for hip fracture risk assessment based on BMI alone could exclude from treatment a significant number of high risk patients. |
| Databáze: | OpenAIRE |
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