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Predicting the Subsequent Contralateral Hip Fracture: Is FRAX the Answer?
Ariana Lott1, Emily M Pflug, Rown Parola
1NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, NY.
Journal of Orthopaedic Trauma
|November 18, 2022
Summary
The Fracture Risk Assessment Tool (FRAX) effectively identifies patients at high risk for contralateral hip fractures. Older age and lower BMI increase this risk, necessitating aggressive preventative measures for early intervention.
Area of Science:
- Orthopedics
- Geriatric Medicine
- Public Health
Background:
- Hip fractures pose a significant health burden, particularly in the elderly.
- Assessing future fracture risk after an initial hip fracture is crucial for timely intervention.
Purpose of the Study:
- To evaluate the Fracture Risk Assessment Tool (FRAX) for predicting contralateral hip fractures within two years.
- To identify independent risk factors for subsequent hip fractures in patients with a prior hip fracture.
Main Methods:
- Retrospective analysis of 832 patients treated for unilateral hip fractures between 2015 and 2019.
- Utilized FRAX scores to assess fracture probability and identified risk factors through statistical analysis.
Main Results:
- 3.7% of patients experienced a contralateral hip fracture within two years.
- FRAX score demonstrated moderate ability (AUROC 0.682) in predicting subsequent fractures.
- Independent risk factors for contralateral hip fracture included age (≥80 years) and decreasing Body Mass Index (BMI).
Conclusions:
- The FRAX score is a valuable tool for identifying patients at high risk of contralateral hip fracture.
- Patients over 80 with decreasing BMI in the high-FRAX group have a significantly elevated risk (12.5%) within two years.
- Aggressive preventative strategies are recommended for high-risk individuals identified by FRAX.
