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A simple score for estimating the long-term risk of fracture in patients with multiple sclerosis

A simple score for estimating the long-term risk of fracture in patients with multiple sclerosis
A simple score for estimating the long-term risk of fracture in patients with multiple sclerosis
Objective: To derive a simple score for estimating the long-term risk of osteoporotic and hip fracture in individual patients with MS.
Methods: Using the UK General Practice Research Database linked to the National Hospital Registry(1997–2008), we identified patients with incident MS (n = 5,494). They were matched 1:6 by year of birth, sex, and practice with patients without MS (control subjects). Cox proportional hazards models were used to calculate the long-term risk of osteoporotic and hip fracture. We fitted the regression model with general and specific risk factors, and the final Cox model was converted into integer risk scores.
Results: In comparison with the FRAX calculator, our risk score contains several new risk factors that have been linked with fracture, which include MS, use of antidepressants, use of anticonvulsants, history of falling, and history of fatigue. We estimated the 5- and 10-year risks of osteoporotic and hip fracture in relation to the risk score. The C-statistic was moderate (0.67) for the prediction of osteoporotic fracture and excellent (0.89) for the prediction of hip fracture.
Conclusion: This is the first clinical risk score for fracture risk estimation involving MS as a risk
factor.
0028-3878
922-928
Bazelier, Marloes T.
701385a8-2cb1-4258-88a4-249c3a7f07f5
van Staa, Tjeerd-Pieter
f840d545-0e8d-40fe-9124-976826190cc3
Uitdehaag, Bernard M. J.
ab730384-edbf-48d0-9847-b7123ec79e5e
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Leufkens, Hubert G. M.
3c6f2841-6825-4de0-b967-1d4aa5498a5d
Vestergaard, Peter
3336d4f1-072c-4b02-935e-a5eca05858e2
Bentzen, Joan
a383095f-902b-4a02-af2a-71d20daaeae2
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1
Bazelier, Marloes T.
701385a8-2cb1-4258-88a4-249c3a7f07f5
van Staa, Tjeerd-Pieter
f840d545-0e8d-40fe-9124-976826190cc3
Uitdehaag, Bernard M. J.
ab730384-edbf-48d0-9847-b7123ec79e5e
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Leufkens, Hubert G. M.
3c6f2841-6825-4de0-b967-1d4aa5498a5d
Vestergaard, Peter
3336d4f1-072c-4b02-935e-a5eca05858e2
Bentzen, Joan
a383095f-902b-4a02-af2a-71d20daaeae2
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1

Bazelier, Marloes T., van Staa, Tjeerd-Pieter, Uitdehaag, Bernard M. J., Cooper, Cyrus, Leufkens, Hubert G. M., Vestergaard, Peter, Bentzen, Joan and de Vries, Frank (2012) A simple score for estimating the long-term risk of fracture in patients with multiple sclerosis. Neurology, 79 (9), 922-928. (doi:10.1212/WNL.0b013e318266faae). (PMID:22895583)

Record type: Article

Abstract

Objective: To derive a simple score for estimating the long-term risk of osteoporotic and hip fracture in individual patients with MS.
Methods: Using the UK General Practice Research Database linked to the National Hospital Registry(1997–2008), we identified patients with incident MS (n = 5,494). They were matched 1:6 by year of birth, sex, and practice with patients without MS (control subjects). Cox proportional hazards models were used to calculate the long-term risk of osteoporotic and hip fracture. We fitted the regression model with general and specific risk factors, and the final Cox model was converted into integer risk scores.
Results: In comparison with the FRAX calculator, our risk score contains several new risk factors that have been linked with fracture, which include MS, use of antidepressants, use of anticonvulsants, history of falling, and history of fatigue. We estimated the 5- and 10-year risks of osteoporotic and hip fracture in relation to the risk score. The C-statistic was moderate (0.67) for the prediction of osteoporotic fracture and excellent (0.89) for the prediction of hip fracture.
Conclusion: This is the first clinical risk score for fracture risk estimation involving MS as a risk
factor.

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Published date: August 2012
Organisations: Faculty of Medicine

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Local EPrints ID: 346509
URI: https://eprints.soton.ac.uk/id/eprint/346509
ISSN: 0028-3878
PURE UUID: bbc290ba-409a-4930-96c3-3685d7d7cab2
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 20 Dec 2012 16:13
Last modified: 12 Nov 2019 01:57

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Contributors

Author: Marloes T. Bazelier
Author: Tjeerd-Pieter van Staa
Author: Bernard M. J. Uitdehaag
Author: Cyrus Cooper ORCID iD
Author: Hubert G. M. Leufkens
Author: Peter Vestergaard
Author: Joan Bentzen
Author: Frank de Vries

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