Reumatologia clinica · 2025
Improving fracture risk classification in Spain: A 10-year evaluation of a modified FRAX-based algorithm.
СтатьяНазвание и аннотация: Перевод в очереди
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Gomez-Vaquero Carmen, Mora Maribel, González-Giménez Xavier, Marco-Pascual Carla, Medina Pilar, Bianchi Maria Marta, Santo Pilar, Nolla Joan M
Аннотация
OBJECTIVE: Osteoporotic fractures represent a significant clinical and public health burden. Although FRAX is widely used to estimate 10-year fracture risk, its Spanish version underestimates the probability of major osteoporotic fractures (MOF). This study assessed the performance of a modified FRAX-based algorithm, calibrated for the Spanish population, to stratify postmenopausal women into clinically meaningful risk categories.
METHODS: We retrospectively followed 837 women (mean age 62±9 years in 2008) referred for bone densitometry. All MOF over a 10-year period were recorded. Women were initially categorized as low risk (MOFR<3.5%) or high risk (≥10%). Those with MOFR between 3.5% and 10% were reclassified as high risk if they had osteoporosis or if the recalculated MOFR including BMD was ≥7%.
RESULTS: A total of 124 women experienced a MOF (66 vertebral, 39 distal forearm, 10 hip, 9 humerus). Initial risk classification identified 40% of women as low risk (fracture incidence: 9.4%, 95% CI: 6.2-12.5), 42% as intermediate (16.3%, 95% CI: 12.4-20.1), and 18% as high risk (23.5%, 95% CI: 16.7-30.3). After reclassification, 69% were considered low risk (11.0%, 95% CI: 8.4-13.5) and 31% high risk (23.2%, 95% CI: 18.1-28.3).
CONCLUSIONS: The proposed FRAX-based algorithm improves fracture risk classification in Spanish women and supports more rational use of bone densitometry and therapeutic interventions.
METHODS: We retrospectively followed 837 women (mean age 62±9 years in 2008) referred for bone densitometry. All MOF over a 10-year period were recorded. Women were initially categorized as low risk (MOFR<3.5%) or high risk (≥10%). Those with MOFR between 3.5% and 10% were reclassified as high risk if they had osteoporosis or if the recalculated MOFR including BMD was ≥7%.
RESULTS: A total of 124 women experienced a MOF (66 vertebral, 39 distal forearm, 10 hip, 9 humerus). Initial risk classification identified 40% of women as low risk (fracture incidence: 9.4%, 95% CI: 6.2-12.5), 42% as intermediate (16.3%, 95% CI: 12.4-20.1), and 18% as high risk (23.5%, 95% CI: 16.7-30.3). After reclassification, 69% were considered low risk (11.0%, 95% CI: 8.4-13.5) and 31% high risk (23.2%, 95% CI: 18.1-28.3).
CONCLUSIONS: The proposed FRAX-based algorithm improves fracture risk classification in Spanish women and supports more rational use of bone densitometry and therapeutic interventions.