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An approach to identifying osteopenic women at increased short-term risk of fracture.
- Source :
-
Archives of internal medicine [Arch Intern Med] 2004 May 24; Vol. 164 (10), pp. 1113-20. - Publication Year :
- 2004
-
Abstract
- Background: Identification and management of women to reduce fractures is often limited to T scores less than -2.5, although many fractures occur with higher T scores. We developed a classification algorithm that identifies women with osteopenia (T scores of -2.5 to -1.0) who are at increased risk of fracture within 12 months of peripheral bone density testing.<br />Methods: A total of 57 421 postmenopausal white women with baseline peripheral T scores of -2.5 to -1.0 and 1-year information on new fractures were included. Thirty-two risk factors for fracture were entered into a classification and regression tree analysis to build an algorithm that best predicted future fracture events.<br />Results: A total of 1130 women had new fractures in 1 year. Previous fracture, T score at a peripheral site of -1.8 or less, self-rated poor health status, and poor mobility were identified as the most important determinants of short-term fracture. Fifty-five percent of the women were identified as being at increased fracture risk. Women with previous fracture, regardless of T score, had a risk of 4.1%, followed by 2.2% in women with T scores of -1.8 or less or with poor health status, and 1.9% for women with poor mobility. The algorithm correctly classified 74% of the women who experienced a fracture.<br />Conclusions: This classification tool accurately identified postmenopausal women with peripheral T scores of -2.5 to -1.0 who are at increased risk of fracture within 12 months. It can be used in clinical practice to guide assessment and treatment decisions.
- Subjects :
- Age Distribution
Aged
Aged, 80 and over
Algorithms
Cohort Studies
Densitometry
Female
Follow-Up Studies
Fractures, Spontaneous diagnosis
Humans
Incidence
Middle Aged
Probability
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Bone Density physiology
Fractures, Spontaneous epidemiology
Fractures, Spontaneous etiology
Osteoporosis, Postmenopausal complications
Osteoporosis, Postmenopausal diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0003-9926
- Volume :
- 164
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Archives of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 15159269
- Full Text :
- https://doi.org/10.1001/archinte.164.10.1113