Bone Abstracts

Background: Asian-specific prediction model for estimating the individual risk of osteoporotic fracture was rare. We aimed to develop a Korean fracture risk prediction model using clinical risk factors and assess external validity of the final model.

Methods: A total of 718,306 Korean men and women aged 50–90 were followed for 7 years in national system based cohort study. Fifty percent were randomly assigned to the development dataset and 50% to the validation dataset. Clinical risk factors for osteoporotic fracture were assessed at biennial health check. Data on osteoporotic fracture in follow-up period were identified by using the ICD-10 codes and the nationwide database of the National Health Insurance Service (NHIS).

Results: During the follow-up period, 19,840 osteoporotic fractures were reported (4889 in men and 14,951 in women) in the development dataset. The assessment tool, called the Korean Fracture Risk Score (KFRS) is comprised of a set of nine variables that include age, BMI, recent fragility fracture, current smoking, high alcohol intake, lack of regular exercise, recent use of oral glucocorticoid, rheumatoid arthritis and other causes of secondary osteoporosis. The KFRS was shown to be predictive of osteoporotic fracture over 7 years. This score was validated using independent dataset. When we compared the mean predicted scores applying the KFRS with the observed risks at 7 years within each 10th of predicted risk, there was close correspondence for overall fracture.

Conclusion: We developed a Korean specific prediction model for osteoporotic fracture. The KFRS can predict risk of fracture in primary population without BMD testing and therefore suitable for use in both clinical setting and for self-assessment. A web site is available at http://www.nhis.or.kr.