The use of 2-, 5-, and 10-year probabilities to characterize fracture risk after a recent sentinel fracture
- PDF / 644,704 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 49 Downloads / 184 Views
ORIGINAL ARTICLE
The use of 2-, 5-, and 10-year probabilities to characterize fracture risk after a recent sentinel fracture J.A. Kanis 1,2 & H. Johansson 1,2 & N.C. Harvey 3,4 & V. Gudnason 5,6 & G. Sigurdsson 5 & K. Siggeirsdottir 5 & M. Lorentzon 1,7 & E. Liu 1 & L. Vandenput 1,8 & W.D. Leslie 9 & E.V. McCloskey 2,10 Received: 8 May 2020 / Accepted: 16 September 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
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. Keywords Fracture probability . FRAX adjustment . Imminent risk . Prior fracture . Risk assessment . Sentinel fracture
Introduction In 2008, the then World Health Organization (WHO) Collaborating Centre for Metabolic Bone Diseases at
* J.A. Kanis [email protected] 1
Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
2
Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK
3
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
4
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Sheffield, UK, released FRAX®, a fracture risk assessment tool for estimating individualized 10-year probability of hip and major osteoporotic fracture (MOF; hip, clinical spine, dista
Data Loading...
