Prediction of absolute risk of fragility fracture at 10 years in a Spanish population: validation of the WHO FRAX ™ tool in Spain

BMC Musculoskeletal Disorders

Study Protocol

Rafael Azagra¹  Yolanda Fernandez²  Adolf Diez-Perez³  Marta Zwart⁴  Daniel Prieto⁵  Genís Roca⁶  Emili Gene⁷  Sílvia Solà⁸  Gloria Encabo⁹  Núria Puchol^1,10  Milagros Iglesias^1,10  Francesc López-Expósito^1,11  Pilar Sancho^1,12  Victòria Sabaté^1,13  Amada Aguyé^1,14  Sílvia Güell^1,15  Sergio Ortiz^1,16  Pere Torán^1,17  Enrique Casado^1,18 

[1] Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Primary Healthcare Centre Badia del Vallès, Catalan Health Institute., C/ Bética s/n, 08214, Badia del Vallès (Barcelona), Spain;Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OX3 7LD, Oxford, UK;Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Internal Medicine Service, IMIM-Hospital del Mar. Department of Medicine, Universitat Autònoma de Barcelona, Psg Marítim 25, 08003, Barcelona, Spain;Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Primary Healthcare Centre Can Gibert del Plà-Girona-2, Catalan Health Institute, C/ Sant Sebastià 50, 17005, Girona, Spain;Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Primary Healthcare Centre Passeig Sant Joan, Catalan Health Institute, Psg de Sant Joan 267, 08035, Barcelona, Spain;Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Primary Healthcare Centre Sant Llàtzer, Sanitary Consortium of Terrassa, C/ de la Riba 62, 08221, Terrassa (Barcelona), Spain;Emergency Department, Hospital de Sabadell, Sanitary Consortium of Parc Taulí, Universitat Autònoma de Barcelona, Parc Tauli s/n, 08208, Sabadell (Barcelona), Spain;Emergency Department, University Hospital of Bellvitge, Catalan Health Institute. University of Barcelona, C/ de la Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat (Barcelona), Spain;Nuclear Medicine Service, Vall d'Hebrón University Hospital, Psg Vall d'Hebrón 119-129, 08035, Barcelona, Spain;Primary Healthcare Centre Badia del Vallès, Catalan Health Institute., C/ Bética s/n, 08214, Badia del Vallès (Barcelona), Spain;Primary Healthcare Centre Bon Pastor, C/ Mollerussa s/n, 08030, Barcelona, Spain;Primary Healthcare Centre Corbera de Llobregat, Catalan Health Institute, C/ Buenos Aires 9, 08757, Corbera de Llobregat (Barcelona), Spain;Primary Healthcare Centre Creu Alta, Catalan Health Institute, C/ Castellar del Vallès 222, 08280, Sabadell (Barcelona), Spain;Primary Healthcare Centre Granollers Centre, Catalan Health Institute, C/ Museu 19, 08400, Granollers (Barcelona), Spain;Primary Healthcare Centre Montcada i Reixach, Catalan Health Institute, Psg de Jaume I s/n, 08110, Montcada i Reixac (Barcelona), Spain;Primary Healthcare Centre Serraparera, Catalan Health Institute, Avda Diagonal s/n, 08290, Cerdanyola del Vallès (Barcelona), Spain;Primary Healthcare Research Support Unit Metropolitana Nord, Catalan Health Institute-IDIAP Jordi Gol, Rambla 227, 08223, Sabadell (Barcelona), Spain;Rheumatology Department, Hospital de Sabadell, Sanitary Consortium of Parc Taulí, Universitat Autònoma de Barcelona, Parc Tauli s/n, 08208, Sabadell (Barcelona), Spain;

关键词: Bone Mineral Density;    Osteoporosis;    Fracture Risk;    Osteoporotic Fracture;    Fragility Fracture;   

DOI  :  10.1186/1471-2474-12-30

 received in 2010-12-29, accepted in 2011-01-28,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAge-related bone loss is asymptomatic, and the morbidity of osteoporosis is secondary to the fractures that occur. Common sites of fracture include the spine, hip, forearm and proximal humerus. Fractures at the hip incur the greatest morbidity and mortality and give rise to the highest direct costs for health services. Their incidence increases exponentially with age.Independently changes in population demography, the age - and sex- specific incidence of osteoporotic fractures appears to be increasing in developing and developed countries. This could mean more than double the expected burden of osteoporotic fractures in the next 50 years.Methods/DesignTo assess the predictive power of the WHO FRAX™ tool to identify the subjects with the highest absolute risk of fragility fracture at 10 years in a Spanish population, a predictive validation study of the tool will be carried out. For this purpose, the participants recruited by 1999 will be assessed. These were referred to scan-DXA Department from primary healthcare centres, non hospital and hospital consultations. Study population: Patients attended in the national health services integrated into a FRIDEX cohort with at least one Dual-energy X-ray absorptiometry (DXA) measurement and one extensive questionnaire related to fracture risk factors. Measurements: At baseline bone mineral density measurement using DXA, clinical fracture risk factors questionnaire, dietary calcium intake assessment, history of previous fractures, and related drugs. Follow up by telephone interview to know fragility fractures in the 10 years with verification in electronic medical records and also to know the number of falls in the last year. The absolute risk of fracture will be estimated using the FRAX™ tool from the official web site.DiscussionSince more than 10 years ago numerous publications have recognised the importance of other risk factors for new osteoporotic fractures in addition to low BMD. The extension of a method for calculating the risk (probability) of fractures using the FRAX™ tool is foreseeable in Spain and this would justify a study such as this to allow the necessary adjustments in calibration of the parameters included in the logarithmic formula constituted by FRAX™.

【 授权许可】

CC BY   
© Azagra et al; licensee BioMed Central Ltd. 2011