Skip Navigation



QJM Advance Access published online on September 23, 2006
QJM, doi:10.1093/qjmed/hcl094
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
99/10/673    most recent
hcl094v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by van Staa, T.P.
Right arrow Articles by Cooper, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by van Staa, T.P.
Right arrow Articles by Cooper, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: Journals.permissions@oxfordjournals.org
Received March 3, 2006
Accepted May 26, 2006

Original Papers

A simple clinical score for estimating the long-term risk of fracture in post-menopausal women

T.P. van Staa 1, P. Geusens 2, J.A. Kanis 3, H.G.M. Leufkens 4, S. Gehlbach 5, and C. Cooper 5 *

1 From the Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands; From the MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK
2 From the Department of Rheumatology, University Hospital, Maastricht, Netherlands; From the Limburg University Center, Diepenbeek, Belgium
3 From the Centre for Metabolic Bone Disease (WHO Collaborating Centre), University of Sheffield Medical School, Sheffield, UK
4 From the Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
5 From the MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK

* To whom correspondence should be addressed.
C. Cooper, E-mail: cc{at}mrc.soton.ac.uk


  Abstract

Background: Simple tools are needed to identify patients at high risk of fracture.

Aim: To develop a simple clinical tool for assessing 5-year risk of fracture.

Design: Cohort study.

Methods: The study population consisted of all women aged 50+ included in the THIN Research Database (containing computerized medical records of UK general practices). Using Cox proportional hazards models, a risk score was initially estimated from age, body mass index, and clinical risk factors. The 5-year risk of fracture (survival function) was estimated for each score.

Results: The study population included 366 104 women aged >=50 years (mean follow-up 5.8 years). Of these, 6453 suffered a hip fracture. Several characteristics independently contributed to the fracture risk score (age, body mass index, fracture and fall history, previous diagnoses and use of medication). The 5-year risks for hip fracture for patients with total scores of 10, 30 and 50 were 0.3% (95%CI 0.3-0.4%), 2.2% (95%CI 2.1-2.2%), and 13.1% (95%CI 12.5-13.7%), respectively. A woman aged 65 years with low BMI and a history of both fracture and falling would have a hip fracture risk score of 37, with a corresponding 5-year risk for a hip fracture of 4.1% (4.0-4.2%). The risk score was validated and tested in another population (from GPRD), with a good concurrence between predicted and observed risks of fracture.

Discussion: This risk score predicts the long-term risk of fracture, and could be used for targeting patients for further investigation, such as bone densitometry.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.