Bone Abstracts

Introduction: The FRAX algorithm, by evaluating the 10-year risk of hip and major osteoporotic fractures, weights greatly on the clinicians’ decision to treat a patient with an antiosteoporotic drug. The FRAX tool has recently been validated for the Portuguese population.

With this work, the authors intended to assess FRAX accuracy when retrospectively performed in patients with hip fracture.

Methods: A retrospective cohort study was run, in which 100 patients with hip fracture randomly selected from a Orthopedics Department were enrolled. FRAX tool (without BMD) was performed and patients were questioned about previous or current antiosteoporotic treatment.

Results: From the 100 patients enrolled, 31 couldn’t cooperate (because of dementia or other medical intercurrences). Amongst the 69 patients who could collaborate, 15 were male and 55 were female; mean age was 77.4±9.1; mean BMI was 25.9±4.6 kg/m². Twenty-one patients had a history of previous fracture; five patients reported parents hip fracture; twp patients were current smokers and five were current alcohol drinkers; four patients had systemic corticosteroid therapy history and four had secondary osteoporosis; none of the patients had rheumatoid arthritis. Only eight patients were under treatment with antiosteoporotic drugs.

Mean risk for major osteoporotic fracture at 10 years was 14.9±9.7% and for hip fracture was 8.0±8.4%. 55 patients had a risk for major osteoporotic fracture <20% and 15 patients had a mean risk for hip fracture at 10 years <3%. All medicated patients had a FRAX calculated risk for hip fracture at 10 years >3%.

Conclusions: In this cohort, established threshold for high risk for hip fracture FRAX algorithm missed 21.7% of the patients who actually had a hip fracture. Only 14.8% of the patients with high risk for hip fracture were being treated with antiosteoporotic drugs.