The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

The use of two-, five- and 10-year probabilities to characterise fracture risk after a recent sentinel fracture

The use of two-, five- and 10-year probabilities to characterise fracture risk after a recent sentinel fracture
The use of two-, five- and 10-year probabilities to characterise fracture risk after a recent sentinel fracture
Summary
The increase in fracture risk associated with a recent fragility fracture is more appropriately captured using a 10-year fracture probability than 2- or 5-year probabilities.

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 2-, 5-, and 10-year probability of fracture.

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) occurring within the previous 2 years and probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios were used to adjust fracture probabilities over a 2-, 5-, and 10-year time horizon.

Results
As expected, probabilities decreased with decreasing time horizon. Probability ratios varied according to age and the site of sentinel fracture. Probability ratios to adjust for a prior fracture within the previous 2 years were higher the shorter the time horizon, but the absolute increases in fracture probabilities were much reduced. Thus, fracture probabilities were substantially lower with time horizons less than 10 years.

Conclusion
The 10-year probability of fractures is the appropriate metric to capture the impact of the recency of sentinel fractures. The probability ratios provide adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures, adjustments which can readily inform clinical decision-making.
FRAX adjustment, Fracture probability, Imminent risk, Prior fracture, Risk assessment, Sentinel fracture
0937-941X
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
Leslie, William D.
5b2dd5d6-4569-40a3-a9b1-95152d11e4f1
McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
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
Leslie, William D.
5b2dd5d6-4569-40a3-a9b1-95152d11e4f1
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, Leslie, William D. and McCloskey, Eugene V. (2020) The use of two-, five- and 10-year probabilities to characterise fracture risk after a recent sentinel fracture. Osteoporosis International. (doi:10.1007/s00198-020-05700-w).

Record type: Article

Abstract

Summary
The increase in fracture risk associated with a recent fragility fracture is more appropriately captured using a 10-year fracture probability than 2- or 5-year probabilities.

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 2-, 5-, and 10-year probability of fracture.

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) occurring within the previous 2 years and probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios were used to adjust fracture probabilities over a 2-, 5-, and 10-year time horizon.

Results
As expected, probabilities decreased with decreasing time horizon. Probability ratios varied according to age and the site of sentinel fracture. Probability ratios to adjust for a prior fracture within the previous 2 years were higher the shorter the time horizon, but the absolute increases in fracture probabilities were much reduced. Thus, fracture probabilities were substantially lower with time horizons less than 10 years.

Conclusion
The 10-year probability of fractures is the appropriate metric to capture the impact of the recency of sentinel fractures. The probability ratios provide adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures, adjustments which can readily inform clinical decision-making.

Text
2- 5- and 10-y probability v3 R1 jk - Accepted Manuscript
Download (181kB)

More information

Accepted/In Press date: 16 September 2020
e-pub ahead of print date: 20 October 2020
Keywords: FRAX adjustment, Fracture probability, Imminent risk, Prior fracture, Risk assessment, Sentinel fracture

Identifiers

Local EPrints ID: 444855
URI: http://eprints.soton.ac.uk/id/eprint/444855
ISSN: 0937-941X
PURE UUID: 1cce9a34-d576-4515-a783-3d82df313f67
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 06 Nov 2020 17:32
Last modified: 20 Oct 2021 04:01

Export record

Altmetrics

Contributors

Author: John A. Kanis
Author: Helena Johansson
Author: Nicholas Harvey ORCID iD
Author: Vilmundur Gudnason
Author: Gunnar Sigurdsson
Author: Kristin Siggeirsdottir
Author: Mattias Lorentzon
Author: Enwu Liu
Author: Liesbeth Vandenput
Author: William D. Leslie
Author: Eugene V. McCloskey

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×