DENVER — The FRAX 10-year fracture risk tool was fairly accurate in predicting the observed number of hip fractures that occurred among more than 5,000 participants of the Framingham Heart Study, according to data presented as a poster at the annual meeting of the American Society for Bone and Mineral Research.
The 10-year observed incidence of hip fracture for women was 117 cases, which did not differ significantly from the FRAX predicted number of 113. For men, the observed incidence was 29 cases, not significantly different from the FRAX prediction of 38, reported Elizabeth J. Samelson, Ph.D., of the Institute for Aging Research in Boston, and her coinvestigators.
FRAX, developed by the World Health Organization, is an online tool to calculate the 10-year probability of hip fracture and major osteoporotic fracture in women and men aged 40–90 years, on the basis of bone mineral density (BMD), gender, age, smoking status, glucocorticoid use, height and weight, diagnosis of rheumatoid arthritis or secondary osteoporosis, history of fracture, and parental history of fracture.
This study included 5,204 Framingham cohort members (2,917 women and 2,287 men) who had a baseline examination between 1987 and 2001 and were followed for hip fracture over 10 years. All were white.
At baseline, patients were assessed for age, body mass index, current smoking status, alcohol consumption, glucocorticoid use, diagnosis of rheumatoid arthritis, prior fragility fracture, parental history of fracture, and T score. Original cohort members (1,456) for whom no parental hip fracture history was available were classified as having no such history. Femoral neck BMD was available for 4,224 participants.
The researchers used FRAX version 3.0 to calculate the 10-year probability of hip fracture and compared the expected number with that observed in the cohort.
Among women aged 40–75 years, the incidence was 52 cases, compared with 57 expected by FRAX; among men aged 40–75 years, the incidence was 12 cases, compared with 23 expected by FRAX.
The observed probability of hip fracture in the oldest adults (aged 76–90 years) exceeded the number predicted by FRAX, while the opposite was true for those aged 40–75. Among women aged 76–90 years, the incidence was 65 cases, compared with 55 expected by FRAX; among men aged 76–90 years, the incidence was 17 cases, compared with 14 expected by FRAX.
The study was supported by the National Institutes of Health. The researchers said they had no relevant financial relationships.
A video about the use of the FRAX tool is at www.youtube.com/clinicalendonews