New Tool Measures 10-Year Fracture Risk

JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 05/2008; 299(14):1651-2. DOI: 10.1001/jama.299.14.1651
Source: PubMed
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    • "In addition, ageing is accompanied by an increasing incidence of chronic diseases, which can impair general health status, and may also indirectly increase the risk for VTE [3]. One such chronic disease is osteoporosis, which leads to an increased risk for fracture, especially when it is associated with other risk factors, such as age, sex, history of fractures, low body mass index (BMI), or a recent fall [4–6]. The occurrence of osteoporotic fracture may in turn lead to immobilisation, hospitalisation, and surgery. "
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    ABSTRACT: In a retrospective cohort study using the General Practice Research Database (GPRD), there was a greater association of venous thromboembolism (VTE) in osteoporotic than in non-osteoporotic female patients. No greater association was shown in treated patients with strontium ranelate or alendronate compared to untreated osteoporotic female patients. We explored the risk of VTE in usual practice in osteoporotic and non-osteoporotic women with and without anti-osteoporotic treatment. A retrospective study was conducted using the GPRD in the UK. The cohorts consisted of untreated osteoporotic women (N = 11,546), osteoporotic women treated with alendronate (N = 20,084), or strontium ranelate (N = 2,408), and a sample of non-osteoporotic women (N = 115,009). Cohorts were compared using a Cox proportional hazards regression model. There was a significantly increased relative risk for VTE in untreated osteoporotic women versus non-osteoporotic women (annual incidence 5.6 and 3.2 per 1,000 patient-years, respectively; relative risk 1.75 [95% confidence interval (CI), 1.09-1.84]). Results were confirmed using adjusted models. The annual incidences of VTE in osteoporotic patients treated with strontium ranelate and alendronate were 7.0 and 7.2 per 1,000 patient-years, respectively, with no significant difference between untreated and treated patients whatever the treatment. Adjusted hazard ratios for treated versus untreated osteoporotic women were 1.09 (95% CI, 0.60-2.01) for strontium ranelate and 0.92 (95% CI, 0.63-1.33) for alendronate. This study shows a greater association of VTE in osteoporotic compared to non-osteoporotic patients, but does not show any greater association in treated patients with strontium ranelate or alendronate compared to untreated osteoporotic patients.
    Osteoporosis International 10/2009; 21(7):1181-7. DOI:10.1007/s00198-009-1050-7 · 4.17 Impact Factor
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    ABSTRACT: Nearly 44 million persons in the United States have osteoporosis or osteopenia, most of whom are osteopenic. Because of sheer numbers, an increased number of fractures occur in the osteopenic group. Bone mineral density alone, based on dual energy X-ray absorptiometry scan results, is not enough to identify persons at increased risk for fracture. The World Health Organization (WHO) Working Group On Osteoporosis has developed an online tool, known as FRAX, to calculate future hip fracture probability based on individual clinical risk factors. Determining the risk of hip fracture is critical because it is the most devastating osteoporosis complication. The FRAX model was developed from population-based cohort studies in Europe, North America, Asia, and Australia. In 2008, the National Osteoporosis Foundation (NOF) adopted the WHO approach in the treatment of osteopenia. This article presents a clinical scenario to demonstrate the application of the WHO FRAX tool and the new NOF guidelines.
    Journal of midwifery & women's health 01/2011; 56(1):61-7. DOI:10.1111/j.1542-2011.2010.00003.x · 1.07 Impact Factor
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    BMJ (online) 04/2011; 342(apr19 1):d2175. DOI:10.1136/bmj.d2175 · 17.45 Impact Factor
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