Osteoporosis Medication Treatment Thresholds for Patients with a Distal Radius Fracture as Determined using Bone Mineral Density and the Fracture Risk Assessment Tool.
- Author:
Jae Woo PARK
1
;
Jung Kyu HUH
;
Joon Yub KIM
;
Joo Han OH
;
Goo Hyun BAEK
;
Hyun Sik GONG
Author Information
1. Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. hsgong@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Bone Density;
Distal radius fracture;
Fracture risk assessment tool;
Osteoporosis
- MeSH:
Aged;
Bone Density;
Female;
Humans;
Osteoporosis;
Radius;
Radius Fractures;
Risk Assessment;
Risk Factors;
Sensitivity and Specificity
- From:Korean Journal of Bone Metabolism
2011;18(1):15-21
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To compare the treatment thresholds for osteoporosis medication based on bone mineral density (BMD) results and fracture risk assessment tool (FRAX) risks in patients with a distal radius fracture. METHODS: The data of 116 consecutive women aged 50~89 years (mean 64.5 years) with a distal radius fracture were collated to identify clinical risk factors, which were inserted into the FRAX algorithm to calculate 10-year fracture risks. Proportions of patients indicated for osteoporosis medication based on BMD alone and based on FRAX risks were determined. Sensitivity estimation was done with FRAX plus BMD as a gold standard measurement for osteoporosis treatment. RESULTS: Of the 116 patients, 38% needed osteoporosis medication based on BMD alone, and 41% were indicated for treatment based on FRAX plus BMD. These proportions were not significantly different (P = 0.481). However, 56% of patients were indicated for treatment based on FRAX excluding BMD, which was significantly larger than the proportion determined by BMD alone (P = 0.001) or FRAX plus BMD (P = 0.003). Sensitivity, specificity, positive predictive value, negative predictive value for BMD alone were 75%, 93%, 90%, 82% and those for FRAX without BMD were 83%, 70%, 69%, 84%. CONCLUSION: No difference was found in the proportion of patients that need osteoporosis medication based on BMD results alone and FRAX plus BMD risks, suggesting BMD measurement can be sufficient to detect candidates for osteoporosis medication in patients with a distal radius fracture. FRAX excluding BMD may include too many patients that do not need osteoporosis treatment.
