Which fractures are most attributable to osteoporosis?
Amy H Warriner1, Nivedita M Patkar, Jeffrey R Curtis
1Division of Endocrinology, Metabolism and Diabetes, The University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Journal of Clinical Epidemiology
|December 7, 2010
Summary
Determining if a fracture is due to osteoporosis is complex. This study used expert consensus and evidence to rank fracture sites by their likelihood of being osteoporosis-related.
Area of Science:
- Orthopedics
- Geriatrics
- Rheumatology
Background:
- The attribution of fractures to osteoporosis remains a subject of clinical and research debate.
- Accurate identification of osteoporosis-related fractures is crucial for patient management and research.
Purpose of the Study:
- To systematically review evidence and establish expert consensus on the likelihood of fractures being osteoporosis-related.
- To stratify fracture sites based on osteoporosis risk factors and clinical presentation.
Main Methods:
- Conducted a systematic literature review and generated an evidence report on fracture risk.
- Convened a multidisciplinary expert panel using the R&D/UCLA appropriateness process.
- Fractures were rated based on likelihood of osteoporosis causation, stratified by age, sex, race/ethnicity, and trauma.
Main Results:
- Femoral neck, pathologic vertebral, and lumbar/thoracic vertebral fractures were most likely osteoporosis-related.
- Open proximal humerus, skull, and facial bone fractures were least likely osteoporosis-related.
- Fracture likelihood varied by demographics; e.g., higher in older Caucasian women than younger African American men for certain fractures.
Conclusions:
- Developed osteoporosis attribution scores for various fracture sites.
- Provided an evidence-based continuum for assessing the likelihood of a fracture being associated with osteoporosis.
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