Publikationer inom Region Kronoberg

*00004579naa a22004453a 4500
*00144632
*00520120706
*008080901s2010    xx ||||      |0|| 0|eng d
*0247 $a10.1186/1471-2474-11-55$2doi
*035  $a(SwePub)oai:services.scigloo.org:133832
*040  $a(SwePub)gu
*042  $9SwePub
*072 7$aart$2swepub-publicationtype
*072 7$aref$2swepub-contenttype
*1001 $aAlbertsson, Daniel
*24510$aHip and fragility fracture prediction by 4-item clinical risk score and mobile heel BMD: a women cohort study
*5203 $aBackground One in four Swedish women suffers a hip fracture yielding high morbidity and mortality. We wanted to revalidate a 4-item clinical risk score and evaluate a portable heel bone mineral density (BMD) technique regarding hip and fragility fracture risk among elderly women. Methods In a population-based prospective cohort study we used clinical risk factors from a baseline questionnaire and heel BMD to predict a two-year hip and fragility fracture outcome for women, in a fracture preventive program. Calcaneal heel BMD was measured by portable dual X-ray laser absorptiometry (DXL) and compared to hip BMD, measured with stationary dual X-ray absorptiometry (DXA) technique. Results Seven women suffered hip fracture and 14 women fragility fracture/s (at hip, radius, humerus and pelvis) among 285 women; 60% having heel BMD ≤ -2.5 SD. The 4-item FRAMO (Fracture and Mortality) Index combined the clinical risk factors age ≥80 years, weight <60 kg, prior fragility fracture, and impaired rise-up ability. Women having 2-4 risk factors showed odds ratio (OR) for hip fracture of 5.9 and fragility fracture of 4.4. High risk group hip fracture risk was 2.8% annually compared to 0.5% for the low risk majority (69%). Heel BMD showed hip fracture OR of 3.1 and fragility fracture OR of 2.6 per SD decrease. For 30 DXA assessed participants mean hip BMD at -2.5 SD level corresponded to a lower BMD at the heel. Five of seven hip fractures occurred within a small risk group of 32 women, identified by high FRAMO Index + prior fragility fracture + heel T-score ≤-3.5 SD. Conclusions In a follow-up study we identified high risk groups for hip and fragility fracture with our plain 4-item risk model. Increased fracture risk was also related to decreasing heel BMD in calcaneal bone, measured with a mobile DXL technique. A combination of high FRAMO Index, prior fragility fracture, and very low BMD restricted the high risk group to 11%, among whom most hip fractures occurred (71%). These practical screening methods could eventually reduce hip fracture incidence by concentrating preventive resources to high fracture risk women.
*650 7$aMEDICIN OCH HÄLSOVETENSKAP$xKlinisk medicin$xDermatologi och venereologi$2hsv//swe$0(SwePub)30204
*650 7$aMEDICAL AND HEALTH SCIENCES$xClinical Medicine$xDermatology and Venereal Diseases$2hsv//eng$0(SwePub)30204
*653  $aDermatologi och venerologi, klinisk genetik, invärtesmedicin
*653  $aDermatology and venerology,clinical genetics, internal medicine
*653  $abone-mineral density
*653  $adual x-ray
*653  $arandomized controlled-trial
*653  $avitamin-d supplementation
*653  $aosteoporotic fractures
*653  $afalls prevention
*653  $apostmenopausal women
*653  $aelderly-women
*653  $awhite women
*653  $ametaanalysis
*7001 $aMellström, Dan,$d1945-$4aut$0(SwePub:scigloo)77459
*7001 $aPetersson, Christer$4aut$0(SwePub:scigloo)108598
*7001 $aThulesius, Hans$4aut$0(SwePub:scigloo)114456
*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 $tBMC Musculosceletal disorders$x1471-2474$g11$q11
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