Författare/Namn
Titel Validation of a 4-item score predicting hip fract ure and mortality risk among elderly women
Anmärkning: Innehållsbeskrivning, sammanfattning PURPOSE: One in 4 Swedish women experiences a hip fract ure, an event that has high concomitant morbidity and mortality. We developed and validated a clinical predictor of fract ure and mortality risk, the Fract ure and Mortality (FRAMO) Index. METHODS: This was a population-based prospective cohort study with a baseline questionnaire and 2-year outcomes of hip fract ure, fragility fract ure, and death. The questionnaire was sent to 1,498 women aged 70 years or older in 3 rural populations, asking them about their age, weight, height, mobility, previous fract ures, smoking, medication use, and housing. Some women were also asked about previous vertebral radiographs. We defined 2 risk models before outcome data collection and subsequently renamed 1 model (age =80 years, weight <60 kg, previous fragility fract ure, and the need to use arms to rise from the sitting position) the FRAMO Index. We used logistic regression analysis to study the association between the FRAMO Index and outcomes in all participants. RESULTS: The participation rate was 83% in this elderly female population (N = 1,248). The 63% of women with 0 to 1 risk fact or had a 2-year hip fract ure risk of 0.8% and mortality risk of 3.2%. In contrast, women with 2 to 4 risk fact ors had a 2-year hip fract ure risk of 5.4% (odds ratio = 7.5; 95% confidence interval, 3.0-18.4) and mortality risk of 23.7% (odds ratio = 9.5; 95% confidence interval, 6.0-14.9). These differences remained significant after adjustment for age as a continuous variable. Mortality increased with the number of risk fact ors. The proportion of women reporting previous vertebral fract ures was higher among the group specifically questioned about vertebral radiographs (P <.001). CONCLUSIONS: The FRAMO Index identified the majority of women who experienced hip fract ures during a 2-year follow-up, who might have been candidates for intensified preventive measures. The FRAMO Index, based on 4 binary risk fact ors, would be pract ical for routine use in primary care.
Ämne
Medarbetare Mellström, Dan, 1945-, Göteborgs universitet, Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa Författare/medförfattare Petersson, Christer Författare/medförfattare Eggertsen, Robert, 1948-, Göteborgs universitet, Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa Författare/medförfattare
Institutionsnamn
Värdpublikation Annals of family medicine ISSN 1544-1717 5:1, s. 48-56 5:1<48-56
Antal i kö:
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*008080901s2007 xx |||| |0|| 0|eng d
*0247 $a17261864$2pmid
*0247 $a10.1370/afm.602$2doi
*0247 $a244469700008$2isi
*035 $a(SwePub)oai:services.scigloo.org:70883
*040 $a(SwePub)gu
*042 $9SwePub
*072 7$aart$2swepub-publicationtype
*072 7$aref$2swepub-contenttype
*1001 $aAlbertsson, Daniel
*24510$aValidation of a 4-item score predicting hip fract ure and mortality risk among elderly women
*5203 $aPURPOSE: One in 4 Swedish women experiences a hip fract ure, an event that has high concomitant morbidity and mortality. We developed and validated a clinical predictor of fract ure and mortality risk, the Fract ure and Mortality (FRAMO) Index. METHODS: This was a population-based prospective cohort study with a baseline questionnaire and 2-year outcomes of hip fract ure, fragility fract ure, and death. The questionnaire was sent to 1,498 women aged 70 years or older in 3 rural populations, asking them about their age, weight, height, mobility, previous fract ures, smoking, medication use, and housing. Some women were also asked about previous vertebral radiographs. We defined 2 risk models before outcome data collection and subsequently renamed 1 model (age =80 years, weight <60 kg, previous fragility fract ure, and the need to use arms to rise from the sitting position) the FRAMO Index. We used logistic regression analysis to study the association between the FRAMO Index and outcomes in all participants. RESULTS: The participation rate was 83% in this elderly female population (N = 1,248). The 63% of women with 0 to 1 risk fact or had a 2-year hip fract ure risk of 0.8% and mortality risk of 3.2%. In contrast, women with 2 to 4 risk fact ors had a 2-year hip fract ure risk of 5.4% (odds ratio = 7.5; 95% confidence interval, 3.0-18.4) and mortality risk of 23.7% (odds ratio = 9.5; 95% confidence interval, 6.0-14.9). These differences remained significant after adjustment for age as a continuous variable. Mortality increased with the number of risk fact ors. The proportion of women reporting previous vertebral fract ures was higher among the group specifically questioned about vertebral radiographs (P <.001). CONCLUSIONS: The FRAMO Index identified the majority of women who experienced hip fract ures during a 2-year follow-up, who might have been candidates for intensified preventive measures. The FRAMO Index, based on 4 binary risk fact ors, would be pract ical for routine use in primary care.
*650 7$aMEDICIN OCH HÄLSOVETENSKAP$2hsv//swe$0(SwePub)3
*650 7$aMEDICAL AND HEALTH SCIENCES$2hsv//eng$0(SwePub)3
*653 $aMedicin
*653 $aMedicine
*653 $aAged
*653 $aAged
*653 $a80 and over
*653 $aFemale
*653 $aGeriatric Assessment
*653 $amethods
*653 $aHealth Status Indicators
*653 $aHip Fract ures
*653 $amortality
*653 $aHumans
*653 $aLogistic Models
*653 $aMale
*653 $aProspective Studies
*653 $aQuestionnaires
*653 $aRisk Assessment
*653 $aRisk Fact ors
*653 $aSensitivity and Specificity
*653 $aSweden
*653 $aepidemiology
*7001 $aMellström, Dan,$d1945-,$uGöteborgs universitet, Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa$4aut$0(SwePub:scigloo)77459
*7001 $aPetersson, Christer$4aut$0(SwePub:scigloo)108598
*7001 $aEggertsen, Robert,$d1948-,$uGöteborgs universitet, Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa$4aut$0(SwePub:scigloo)81440
*7102 $8swe$aGöteborgs universitet.$bSahlgrenska akademin.$bInstitutionen för medicin, avdelningen för samhällsmedicin och folkhälsa.$0(SwePub:scigloo)1624
*7102 $8eng$aUniversity of Gothenburg.$bSahlgrenska Academy.$bInstitute of Medicine, Department of Public Health and Community Medicine.$0(SwePub:scigloo)1624
*7730 $tAnnals of family medicine$x1544-1717$g5:1, s. 48-56$q5:1<48-56
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