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USE OF FRAX® WITHOUT BMD TO ASSESS
RISK OF FRACTURE IN AN OUT-PATIENT POPULATION
Clifford, G.T., Slattery, C., van der Kamp, S., McKenna, M.
Background
• Fractures place a significant burden on thepatient, the hospital and the healthcaresystem in terms of cost, morbidity,mortality. Each year there are 3000 hospitaladmissions due to hip fracture (IHFD2013). Hospital out-patient departments, asmajor healthcare providers to its localcatchment area have an opportunity to beat the forefront of identifying risk of fractureamong its patients.
• FRAX® has been recommended by WHOfor use in identifying patients at risk offracture and has been validated in anumber of populations and healthcaresettings.
Correspondence: [email protected]
17
22
7
0
5
10
15
20
25
Low Intermediate High
Risk of Fracture
LowIntermediateHigh
2 5 512 9 7 9 8
44 39 4032 37 38 37 38
0
10
20
30
40
50
Osteoporosis Risk Factors
YesNoDon't Know
• Nearly 60% of patients warrantedinvestigation and/or treatment forosteoporosis.
Aim
• To identify the risk of fracture in an out-patient population and to determine whowould benefit from osteoporosis treatment.
Methodology
• All patients over 50 years were consideredfor inclusion for this cross-sectional study.
• A convenience sample of 50 patients wasselected from an IV Therapies Suite.
• FRAX® without BMD using clinical riskfactors, age and BMI was used todetermine risk of fracture.
• Data collection included: age, body massindex, current bone protection medications,previous fragility fractures, parental historyof hip fracture, current glucocorticoid use,current smoker and current alcohol use.
• Descriptive statistics were used.
Results
• Of the 50 participants, there were 31males, the median age was 64 years andthe median BMI was 27 kg/m2. Nineteenpatients were on Vitamin D or calciumsupplements. No patients were on boneprotection despite 5 patients with a priorfragility fracture.
Conclusion
• This was an younger, predominately malepopulation in the overweight BMI category.
• Patients require a comprehensiveassessment of both risk of fracture and riskof falling to prevent a harmful fall. The riskfactors for both fracture and falls are notinterchangeable.
• Identifying risk of fracture, and subsequentinvestigation and/or treatment couldsignificantly reduce the risk of fracture andthereby, morbidity, mortality and cost.
1420
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1
2
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25
Low Intermediate High
Falls v Risk of Fracture
≥210
