Background FRAX tool has been developed by the World Health Organization (WHO) to estimate the 10-year fracture probability in men and women from clinical risk factors, age, sex and body mass index with or without the measurement of femoral neck bone mineral density1.
Objectives To evaluate the differences in the Portuguese population in the FRAX 10 year probability of fracture and reported risk factors for osteoporosis (OP), comparing the general population and a high risk fracture (HRF) population.
Methods Cross sectional survey was performed including subjects representative of the Portuguese population aged ≥50 years(selected by random route method, door to door) and a HRF population (convenience sample, selected from nursing homes and long term facilities in Portugal). Inclusion criteria for HRF population are age ≥50 years, history of femoral neck fracture on the 24 months prior, absence of cognitive limitations. The overall and HRF population included demographics and clinical variables. The FRAX 10 year probabilities of hip and major osteoporotic fractures were calculated, according to the Spanish algorithm and reported risk factors for OP were collected. Descriptive analysis was performed, including relative frequencies for categorical variables and mean ± standard deviation for continuous variables. T-test was performed to validate study hypothesis. Confidence intervals (CI) of 95% will be determined and all calculations were performed assuming a 5% significance level.
Results The analyses included 2007 subjects from the general population (mean age of 65.3±10.4 years, 55.2% female). 62 subjects self-reported OP (3.1%; 95% CI: 2.4%>3.9%). The HRF population included 419 subjects (mean age 78.3±7.8, 70.4% female). In general population, the probability of a major osteoporotic fracture was 5.0±5.3 and 2.1±3.7 for hip fracture. This values were statistically higher for subjects in general population with self-reported OP (Major Osteoporotic: 11.0±11.8 vs. 4.8±4.8; p<0.001; Hip Fracture: 6.1±10.6 vs. 1.9±3.1; p=0.003). The probability of a major osteoporotic fracture in HRF population was 20.7±11.4. Considering hip fracture, HRF population had a mean probability of 12.1±9.6. No significant differences were found in the HRF population between subjects with and without self-reported OP.
Conclusions As expected, subjects in HRF population (that already had suffered a previous fracture) have a higher risk for major osteoporotic and hip fractures when compared with the general population.
Kanis JA, Oden A, Johansson H, Borgström F, Ström O, McCloskey E. FRAX and its applications to clinical practice. Bone 2009;44(5):734-43.
Disclosure of Interest None Declared
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