Loading...
Adjusting conventional FRAX estimates of fracture probability according to the number of prior falls in the preceding year
Kanis, John A. Johansson, Helena Harvey, Nicholas C. Lorentzon, Mattias Liu, Enwu Vandenput, Liesbeth Morin, Suzanne Leslie, William D. McCloskey, Eugene V.
Kanis, John A.
Johansson, Helena
Harvey, Nicholas C.
Lorentzon, Mattias
Liu, Enwu
Vandenput, Liesbeth
Morin, Suzanne
Leslie, William D.
McCloskey, Eugene V.
Abstract
Summary
A greater propensity to falling is associated with higher fracture risk. This study provides adjustments to FRAX-based fracture probabilities accounting for the number of prior falls.
Introduction
Prior falls increase subsequent fracture risk but are not currently directly included in the FRAX tool. The aim of this study was to quantify the effect of the number of prior falls on the 10-year probability of fracture determined with FRAX®.
Methods
We studied 21,116 women and men age 40 years or older (mean age 65.7 ± 10.1 years) with fracture probability assessment (FRAX®), self-reported falls for the previous year, and subsequent fracture outcomes in a registry-based cohort. The risks of death, hip fracture, and non-hip major osteoporotic fracture (MOF-NH) were determined by Cox proportional hazards regression for fall number category versus the whole population (i.e., an average number of falls). Ten-year probabilities of hip fracture and major osteoporotic fracture (MOF) were determined according to the number of falls from the hazards of death and fracture incorporated into the FRAX model for the UK. The probability ratios (number of falls vs. average number of falls) provided adjustments to conventional FRAX estimates of fracture probability according to the number of falls.
Results
Compared with the average number of falls, the hazard ratios for hip fracture, MOF-NH and death were lower than unity in the absence of a fall history. Hazard ratios increased progressively with an increasing number of reported falls. The probability ratio rose progressively as the number of reported falls increased. Probability ratios decreased with age, an effect that was more marked the greater the number of prior falls.
Conclusion
The probability ratios provide adjustments to conventional FRAX estimates of fracture probability according to the number of prior falls.
Keywords
fracture probability, FRAX adjustment, prior falls, risk assessment
Date
2023
Type
Journal article
Journal
Osteoporosis International
Book
Volume
34
Issue
3
Page Range
479-487
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled