49 Falls and the Prediction of Fragility Fractures

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Celia Gregson
Keyword(s):  
Risk Assessment ◽  
Fracture Risk ◽  
Fragility Fractures ◽  
Fracture Risk Assessment ◽  
Assessment Tools ◽  
Health And Social Care ◽  
European Working ◽  
Risk Assessment Tools ◽  
History Of ◽  
Risk Factors For Falls

Abstract Fragility fractures carry high health and social care costs for patients, families, and health systems. Falls are a fundamental risk factor for sustaining a fragility fracture, and hence fracture risk assessment is an intrinsic component of any falls evaluation. I will review the relationship between falls and incident fracture and outline strategies for assessing fracture risk. I will review the different fracture risk assessment tools available, including FRAX. I will discuss approaches to fracture risk assessment in the context of falls. Sarcopenia is an important risk factors for falls. Recently the European Working Group on Sarcopenia in Older People (EWGSOP) updated their diagnostic criteria for sarcopenia, placing a greater emphasis on muscle strength and physical performance. Whilst measures of muscle mass may not add to the clinical prediction of fractures over an above a tool such as FRAX, I will discuss the value of tests of muscle function, impairment of which characterises sarcopenia, in the prediction of fracture risk. I will further present data on patient’s own perception of fracture risk and how this might be influenced by a history of falls.

Comparison of CAROC and FRAX in Fragility Fracture Patients: Agreement, Clinical Utility, and Implications for Clinical Practice

2016 ◽  
Vol 43 (8) ◽  
pp. 1593-1599 ◽  
Author(s):  
Nooshin Khobzi Rotondi ◽  
Dorcas E. Beaton ◽  
Victoria Elliot-Gibson ◽  
Rebeka Sujic ◽  
Robert G. Josse ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Fracture Risk ◽  
Fragility Fracture ◽  
Fragility Fractures ◽  
Fracture Risk Assessment ◽  
Assessment Tools ◽  
Urban Hospital ◽  
Canadian Association ◽  
Risk Assessment Tools ◽  
Level Of Agreement

Objective.To examine the level of agreement between 2 fracture risk assessment tools [Canadian Association of Radiologists and Osteoporosis Canada (CAROC) and Canadian Fracture Risk Assessment (FRAX)] when applied within the context of the Canadian guidelines, in a population of fragility fracture patients.Methods.The sample consisted of 135 treatment-naive fragility fracture patients aged 50+ years and screened as part of an osteoporosis (OP) program at an urban hospital. Ten-year probabilities of future major osteoporotic fractures were calculated using the FRAX and CAROC. We also integrated additional qualifiers from the 2010 Canadian guidelines that place hip, spine, and multiple fractures at high risk regardless. A quadratic weighted κ (Kw) and 95% CI were calculated to estimate the chance corrected agreement between the risk assessment tools. Logistic regression was used to evaluate the factors associated with concordance.Results.Among patients with fragility fractures, the agreement between CAROC and FRAX was Kw = 0.64 (95% CI 0.58–0.71), with 45 of 135 cases in the cells reflecting disagreement. Younger persons and males were more likely to be found in discordant cells.Conclusion.The level of agreement between 2 commonly used fracture risk assessment tools was not as high in the patients with fragility fractures as it was in general community-based samples. Our results suggest discordance is found in less-typical patients with OP who need more consistency in messaging and direction. Users of these fracture risk tools should be aware of the potential for discordance and note differences in risk classifications that may affect treatment decisions.

A comparison of electronic and manual fracture risk assessment tools in screening elderly male US veterans at risk for osteoporosis

2017 ◽  
Vol 28 (11) ◽  
pp. 3107-3111 ◽  
Author(s):  
S. T. Williams ◽  
P. T. Lawrence ◽  
K. L. Miller ◽  
J. L. Crook ◽  
J. LaFleur ◽  
...  
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Fracture Risk ◽  
Fracture Risk Assessment ◽  
Assessment Tools ◽  
Elderly Male ◽  
Risk Assessment Tools ◽  
Us Veterans

Treatment Thresholds for Osteoporosis and Reimbursability Criteria: Perspectives Associated with Fracture Risk-Assessment Tools

2013 ◽  
Vol 93 (3) ◽  
pp. 195-200 ◽  
Author(s):  
Silvano Adami ◽  
Francesco Bertoldo ◽  
Davide Gatti ◽  
Giovanni Minisola ◽  
Maurizio Rossini ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Fracture Risk ◽  
Fracture Risk Assessment ◽  
Assessment Tools ◽  
Risk Assessment Tools ◽  
Treatment Thresholds

scholarly journals Osteoporosis Canada 2010 Guidelines for the Assessment of Fracture Risk

2011 ◽  
Vol 62 (4) ◽  
pp. 243-250 ◽  
Author(s):  
◽  
Brian Lentle ◽  
Angela M. Cheung ◽  
David A. Hanley ◽  
William D. Leslie ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Clinical Practice ◽  
Fracture Risk ◽  
Fragility Fractures ◽  
Clinical Impact ◽  
Assessment Tools ◽  
Management Approach ◽  
Concerted Effort ◽  
Risk Assessment Tools ◽  
Fracture Risk Prediction

Osteoporosis Canada's 2010 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada focus on the clinical impact of fragility fractures, and on the assessment and management of women and men at high risk for fragility fracture. These guidelines now integrate a 10-year absolute fracture risk prediction into an overall management approach by using validated risk assessment tools. There currently is a large gap between optimal practices and those that are now being provided to Canadians with osteoporosis. These guidelines are part of a concerted effort to close this gap. Key changes from the 2002 guidelines of interest and relevance to radiologists are highlighted in this report.

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