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OP0205-PC Assessing Risk of Fracture in Primary Care: FRAX and QFracture
  1. M. D. Medina Abellán1,
  2. M. García-Palacios1,
  3. T. Martín- Casquero1,
  4. F. G. Torres-Ruiz1,
  5. A. Serrano-Noguera1,
  6. M. D. Pérez-Cárceles2
  1. 1Primary Care, Servicio Murciano Salud
  2. 22Department of Legal and Forensic Medicine, University of Murcia, Murcia, Spain

Abstract

Background Two algorithms have become available to estimate the 10-year probability of fracture in patients suspected to have osteoporosis on the basis of clinical risk factors: the FRAX and QFractureScores.

Objectives To know if our patients diagnosed of osteoporosis have high risk of fracture (mayor or hip) in 10 years time by both algorithms.

Methods It is a descriptive, transversal, observational and retrospective study. Randomly selected 225 patients diagnosed of osteoporosis that came to our urban Health Center for any other reason.

We measured different risks factors from both tests: age, gender, weight, height, parents fractures, parents diagnosed of osteoporosis, smoking habit, steroids intake, rheumatoid arthritis, ethnicity, alcohol intake, diabetes mellitus, femoral neck BMD, where they live, previous mayor fracture, falls, dementia, cancer, asthma or COPD, heart attack or stroke, chronic liver or renal disease, Parkinson, lupus, malabsorption, endocrine problem, epilepsy, tricyclic antidepressants, hormone-replacement therapy.

Results 96,9% were women, average age 70,59 (37-93 age range). The average height was 154,76 cm (±5,90) and average weight 69,98 kg (±11,30).37,1% had a previous fracture but 26,7% had a mayor fracture (spine, hip or shoulder).41,8% had history of falls. Only 12,4% are smokers and 2,2% take more than 3 UBs/day. Rheumatoid arthritis is diagnosed in 1,8% patients. 26,2% have diabetes type 2; 10,7% have history of cancer; 9,3% were diagnosed from COPD or asthma and 90,2% did not have heart attack, angina, stroke or TIA and also 98,2% did not have chronic liver disease. Just 1,3% had chronic liver disease and 4,0 had chronic kidney disease; 2,2% were diagnosed Parkinson´s disease and just 0,9% had lupus. 4,4% the patients had endocrine problems considering the QFracture calculator. Up to 27,6% were taking antidepressants. 94,7% didn´t take HRT.

When describing their parents, 76,4% did not have history of fracture and the 52,0% didn´t have osteoporosis.

Just 111 patients had T- Score measured, average -1,71 (±1,20). The average risk of mayor fracture in 10 years time measured by FRAX is 8,98 ±8,60 (range: 1,00-88,00) but when we measured this risk with QFracture calculator is 11,53 ± 9,40 (0,03-51,60). The risk for hip fracture in 10 years was 3,74 ± 7,35 for FRAX and 6,12± 7,89 for QFracture.

Conclusions Both FRAX and QFracture algorithms are useful in General Practice in fracture risk estimation and prevention of fractures. Unfortunately, QFracture is not validated for Spanish population.

References

  1. Predcting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. Hippisley-Cox, J. BMJ 2009, 339:B4229. Doi:10.1136/bmj.b4229

  2. Evaluación de una propuesta de criterios de indicación de densitometría ósea en mujeres posmenopáusicas españolas basados en la herramienta FRAX. Gómez-Vaquero, C; Roig-Vilaseca, D; Bianchi, M; Santo, P; Narváez, J; Nolla, JM. Med Clin (Barc).2012. doi.10.10161/i.medcli.2012.03.008

Disclosure of Interest None Declared

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