Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
To What Degree Does the FRAX Case Finding Algorithm Underestimates Fracture Risk in Patients with a Recent Fall?
Geusens, Piet P. M. M.
Identifying patients at highest risk for fracture starts with clinical case finding, based on the presence of well-documented bone and fall-related clinical risk factors for fractures. The FRAX algorithm does not include risk factors for falls. The Fracture Prediction Tool in Glucocorticosteriod users (FIGS) includes a history of recent falls and the Garvan algorithm the number of recent falls.
We compared FRAX with FIGS and Garvan to calculate the 10-year risk of major fractures (FRAX: clinical spine, hip, forearm an humerus; FIGS: also rib, femur and pelvis fractures; Garvan: all low-trauma fractures).
In 60 yr old subjects with a body weight of 70 kg without clinical fracture risks, calculated fracture risk was 6.0% with FRAX, 6.9% with FIGS and 9.4% with Garvan. After a recent fall, the fracture risk increased with FIGS (14.3%) and Garvan (11.4% after one fall up to 16.7% after 3 falls). After a history of fracture, the fracture risk increased with all algorithms compared to patients without a recent fall (FRAX: 12.0%, FIGS: 12.0%, Garvan:16.1%), but further increased substantially if they had a recent fall (FIGS: 24.0%. Garvan: 19.3% after one fall up to 27.6% after 3 falls). Similar differences in fracture prediction between the algorithms were found in 70 or 80 yr old subjects and in subjects with a low or high body weight.
We conclude that FRAX substantially underestimates fracture risk in subjects who have as only risk factors a history of a recent fall or a recent fall-related fracture.
To cite this abstract, please use the following information:
Geusens, Piet P. M. M.; To What Degree Does the FRAX Case Finding Algorithm Underestimates Fracture Risk in Patients with a Recent Fall? [abstract]. Arthritis Rheum 2009;60 Suppl 10 :873