Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures
Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures
Summary: the risk of a recurrent fragility fracture is particularly high immediately following the fracture. This study provides adjustments to FRAX-based fracture probabilities accounting for the site of a recent fracture.
Introduction: the recency of prior fractures affects subsequent fracture risk. The aim of this study was to quantify the effect of a recent sentinel fracture, by site, on the 10-year probability of fracture determined with FRAX.
Methods: the study used data from the Reykjavik Study fracture register that documented prospectively all fractures at all skeletal sites in a large sample of the population of Iceland. Fracture probabilities were determined after a sentinel fracture (humeral, clinical vertebral, forearm and hip fracture) from the hazards of death and fracture. Fracture probabilities were computed on the one hand for sentinel fractures occurring within the previous 2 years and on the other hand, probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios provided adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.
Results: probability ratios to adjust 10-year FRAX probabilities of a major osteoporotic fracture for recent sentinel fractures were age dependent, decreasing with age in both men and women. Probability ratios varied according to the site of sentinel fracture with higher ratios for hip and vertebral fracture than for humerus or forearm fracture. Probability ratios to adjust 10-year FRAX probabilities of a hip fracture for recent sentinel fractures were also age dependent, decreasing with age in both men and women with the exception of forearm fractures.
Conclusion: the probability ratios provide adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.
FRAX adjustment, Fracture probability, Imminent risk, Prior fracture, Risk assessment, Sentinel fracture
1817-1828
Kanis, John A.
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Johansson, Helena
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Harvey, Nicholas
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Gudnason, Vilmundur
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Sigurdsson, Gunnar
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Siggeirsdottir, Kristin
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Lorentzon, Mattias
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Liu, Enwu
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Vandenput, Liesbeth
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McCloskey, Eugene V.
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1 October 2020
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Gudnason, Vilmundur
75cefe2e-c5f6-4d85-9a92-cd8c29dd6a94
Sigurdsson, Gunnar
53162212-0166-486a-8e94-4647c645d882
Siggeirsdottir, Kristin
bc469433-457c-420a-99c5-ef774c9ae4af
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Vandenput, Liesbeth
0910d143-4b58-4579-82b0-3810272f1814
McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
Kanis, John A., Johansson, Helena, Harvey, Nicholas, Gudnason, Vilmundur, Sigurdsson, Gunnar, Siggeirsdottir, Kristin, Lorentzon, Mattias, Liu, Enwu, Vandenput, Liesbeth and McCloskey, Eugene V.
(2020)
Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures.
Osteoporosis International, 31 (10), .
(doi:10.1007/s00198-020-05517-7).
Abstract
Summary: the risk of a recurrent fragility fracture is particularly high immediately following the fracture. This study provides adjustments to FRAX-based fracture probabilities accounting for the site of a recent fracture.
Introduction: the recency of prior fractures affects subsequent fracture risk. The aim of this study was to quantify the effect of a recent sentinel fracture, by site, on the 10-year probability of fracture determined with FRAX.
Methods: the study used data from the Reykjavik Study fracture register that documented prospectively all fractures at all skeletal sites in a large sample of the population of Iceland. Fracture probabilities were determined after a sentinel fracture (humeral, clinical vertebral, forearm and hip fracture) from the hazards of death and fracture. Fracture probabilities were computed on the one hand for sentinel fractures occurring within the previous 2 years and on the other hand, probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios provided adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.
Results: probability ratios to adjust 10-year FRAX probabilities of a major osteoporotic fracture for recent sentinel fractures were age dependent, decreasing with age in both men and women. Probability ratios varied according to the site of sentinel fracture with higher ratios for hip and vertebral fracture than for humerus or forearm fracture. Probability ratios to adjust 10-year FRAX probabilities of a hip fracture for recent sentinel fractures were also age dependent, decreasing with age in both men and women with the exception of forearm fractures.
Conclusion: the probability ratios provide adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.
Text
Publication Imminent risk v5 OSIN Rev
- Accepted Manuscript
More information
Accepted/In Press date: 1 June 2020
e-pub ahead of print date: 1 July 2020
Published date: 1 October 2020
Additional Information:
Funding Information:
We thank the participants in the Reykjavik Study for their valuable contribution. We are particularly grateful to the Committee of Scientific Advisors and the Committee of National Societies of the International Osteoporosis Foundation for their review, constructive comments and endorsement of this position paper.
Publisher Copyright:
© 2020, International Osteoporosis Foundation and National Osteoporosis Foundation.
Keywords:
FRAX adjustment, Fracture probability, Imminent risk, Prior fracture, Risk assessment, Sentinel fracture
Identifiers
Local EPrints ID: 442586
URI: http://eprints.soton.ac.uk/id/eprint/442586
ISSN: 0937-941X
PURE UUID: 9def0e24-f945-4e6a-a759-79d2ff871e1c
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Date deposited: 20 Jul 2020 16:31
Last modified: 17 Mar 2024 05:45
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Contributors
Author:
John A. Kanis
Author:
Helena Johansson
Author:
Vilmundur Gudnason
Author:
Gunnar Sigurdsson
Author:
Kristin Siggeirsdottir
Author:
Mattias Lorentzon
Author:
Enwu Liu
Author:
Liesbeth Vandenput
Author:
Eugene V. McCloskey
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