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High fracture risk in postmenopausal women established by FRAX, Garvan, and POL-RISK algorithms
Rafał Hebel1, Wojciech Pluskiewicz2, Piotr Adamczyk3
1Open Care Department, Egis Polska, z o.o, Warsaw, Poland. rafal.hebel@gmail.com.
Abstract:
The study presents osteoporotic fracture risk in postmenopausal women established by FRAX, Garvan and POL-RISK algorithms for next 10 years. In studied group, a relatively high level of fracture risk was shown. These findings emphasize the importance of increasing treatment to reduce the expected rise in fracture rate in the future.
Purpose:
The aim of the study was to assess the 10-year osteoporotic fracture risk of postmenopausal women using the FRAX, Garvan, and POL-RISK algorithms and to compare those tools in terms of identification of high-risk subjects.
Methods:
The study group consisted of 508 consecutive postmenopausal women recruited in three osteoporotic outpatient clinics. Mean age was 69.8 ± 7.5 years. Data on clinical risk factors were collected. Bone status was assessed at the hip using a Lunar Prodigy device. Fracture risk was established by FRAX, Garvan, and POL-RISK algorithms for the next 10 years.
Results:
Mean risk for major fractures for FRAX was 8.85 ± 5.43% and for any fractures for Garvan and POL-RISK 29.71 ± 20.53% and 28.1 ± 14.85%, respectively. Mean risk for hip fractures for FRAX was 3.23 ± 3.72% and 13.33 ± 18.30% for Garvan. For FRAX in 185 women (36.4%), hip fracture risk was high (≥ 3%) and in 119 (23.4%) very high ≥ 4.5% and high risk for major fracture was in 159 (31.3%) women (≥ 10%) and very high (≥ 15%) in 64 (12.6%) women. For therapeutic thresholds, high risk for FRAX major fracture, POL-RISK, and Garvan was noted in 316 (62.2%), 374 (73.5%) and 298 (58.5%) women, respectively. The results correlated for any (major) significantly between algorithms FRAX-Garvan r = 0.66, p < 0.001, FRAX-POL-RISK r = 0.60, p < 0.001, and Garvan-POL-RISK r = 0.93, p < 0.001. A stronger relationship was observed between Garvan and POL-RISK than between either of them and FRAX. FRAX hip risk correlated with Garvan hip risk r = 0.57, p < 0.001.
Conclusion:
In studied group, a relatively high level of fracture risk, especially for hip, was shown. Considering these findings, it is advisable to expand the population of postmenopausal women eligible for effective anti-osteoporotic therapy.
