Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women

SummaryRemaining lifetime and absolute 10-year probabilities for osteoporotic fractures were determined by gender, age, and BMD values. Remaining lifetime probability at age 50 years was 20.2% in men and 51.3% in women and increased with advancing age and decreasing BMD. The study validates the elements required to populate a Swiss-specific FRAX® model.IntroductionSwitzerland belongs to high-risk countries for osteoporosis. Based on demographic projections, burden will still increase. We assessed remaining lifetime and absolute 10-year probabilities for osteoporotic fractures by gender, age and BMD in order to populate FRAX® algorithm for Switzerland.MethodsOsteoporotic fracture incidence was determined from national epidemiological data for hospitalised fractured patients from the Swiss Federal Office of Statistics in 2000 and results of a prospective Swiss cohort with almost 5,000 fractured patients in 2006. Validated BMD-associated fracture risk was used together with national death incidence and risk tables to determine remaining lifetime and absolute 10-year fracture probabilities for hip and major osteoporotic (hip, spine, distal radius, proximal humerus) fractures.ResultsMajor osteoporotic fractures incidence was 773 and 2,078 per 100,000 men and women aged 50 and older. Corresponding remaining lifetime probabilities at age 50 were 20.2% and 51.3%. Hospitalisation for clinical spine, distal radius, and proximal humerus fractures reached 25%, 30% and 50%, respectively. Absolute 10-year probability of osteoporotic fracture increased with advancing age and decreasing BMD and was higher in women than in men.ConclusionThis study validates the elements required to populate a Swiss-specific FRAX® model, a country at highest risk for osteoporotic fractures.

[1]  Harry K. Genant,et al.  Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. , 1993, The American journal of medicine.

[2]  S. Cummings,et al.  Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. , 1989, Archives of internal medicine.

[3]  J. Eisman,et al.  Residual Lifetime Risk of Fractures in Women and Men , 2007, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[4]  Kim Brixen,et al.  Ten‐Year Absolute Risk of Osteoporotic Fractures According to BMD T Score at Menopause: The Danish Osteoporosis Prevention Study , 2006, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[5]  K. Lippuner,et al.  Cortical and trabecular bone mineral density in transsexuals after long-term cross-sex hormonal treatment: a cross-sectional study , 2005, Osteoporosis International.

[6]  A. Silman,et al.  Predictive Value of BMD for Hip and Other Fractures , 2005, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[7]  H. Kopera,et al.  Briefe an die Redaktion , 1989, Klinische Wochenschrift.

[8]  A. Kurth,et al.  Diagnostik und Therapie der postmenopausalen Osteoporose und der Osteoporose des Mannes , 2007, Der Orthopäde.

[9]  Claus Christiansen,et al.  Diagnosis of Osteoporosis , 1992, Southern medical journal.

[10]  J. Osieleniec,et al.  Current understanding of osteoporosis according to the position of the World Health Organization (WHO) and International Osteoporosis Foundation. , 2007, Ortopedia, traumatologia, rehabilitacja.

[11]  O. Johnell,et al.  International Variations in Hip Fracture Probabilities: Implications for Risk Assessment , 2002, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[12]  S. Papapoulos,et al.  A New Approach to the Development of Assessment Guidelines for Osteoporosis , 2002, Osteoporosis International.

[13]  H. Wahner,et al.  Updated Data on Proximal Femur Bone Mineral Levels of US Adults , 1998, Osteoporosis International.

[14]  N. Suhm,et al.  Management of fragility fractures in Switzerland: results of a nationwide survey. , 2008, Swiss medical weekly.

[15]  K. Lippuner,et al.  Epidemiology and direct medical costs of osteoporotic fractures in men and women in Switzerland , 2005, Osteoporosis International.

[16]  O Johnell,et al.  Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. , 2000, Bone.

[17]  O. Johnell,et al.  FRAX™ and the assessment of fracture probability in men and women from the UK , 2008, Osteoporosis International.

[18]  Florian Hartl,et al.  Prediction of Hip Fracture Risk by Quantitative Ultrasound in More Than 7000 Swiss Women ≥70 Years of Age: Comparison of Three Technologically Different Bone Ultrasound Devices in the SEMOF Study , 2006, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[19]  D. Hans,et al.  Defining risk thresholds for a 10-year probability of hip fracture model that combines clinical risk factors and quantitative ultrasound: results using the EPISEM cohort. , 2008, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[20]  O. Johnell,et al.  The Burden of Osteoporotic Fractures: A Method for Setting Intervention Thresholds , 2001, Osteoporosis International.

[21]  J. Murabito,et al.  Lifetime Risk for Developing Congestive Heart Failure: The Framingham Heart Study , 2002, Circulation.

[22]  Jacques P. Brown,et al.  Recommendations for bone mineral density reporting in Canada: a shift to absolute fracture risk assessment. , 2007, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[23]  Sudha Seshadri,et al.  Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. , 2006, JAMA.

[24]  Ralph B D'Agostino,et al.  Prediction of Lifetime Risk for Cardiovascular Disease by Risk Factor Burden at 50 Years of Age , 2006, Circulation.

[25]  J. Kanis,et al.  Case finding for the management of osteoporosis with FRAX®—assessment and intervention thresholds for the UK , 2008, Osteoporosis International.

[26]  Everett M. Rogers,et al.  Consensus Development Conference , 1984 .

[27]  H. Johansson,et al.  Development and application of a Japanese model of the WHO fracture risk assessment tool (FRAX™) , 2008, Osteoporosis International.

[28]  Jacques P. Brown,et al.  The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women , 2007, Osteoporosis International.

[29]  P. Mcnair,et al.  Radial and humeral fractures as predictors of subsequent hip, radial or humeral fractures in women, and their seasonal variation , 1993, Osteoporosis International.

[30]  O. Johnell,et al.  Ten-year probabilities of clinical vertebral fractures according to phalangeal quantitative ultrasonography , 2005, Osteoporosis International.

[31]  C. Cooper,et al.  European guidance for the diagnosis and management of osteoporosis in postmenopausal women , 2008, Osteoporosis International.

[32]  Didier Hans,et al.  Assessment of the 10‐Year Probability of Osteoporotic Hip Fracture Combining Clinical Risk Factors and Heel Bone Ultrasound: The EPISEM Prospective Cohort of 12,958 Elderly Women , 2008, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[33]  J. Robine,et al.  Nonagenarians and centenarians in Switzerland, 1860–2001: a demographic analysis , 2004, Journal of Epidemiology and Community Health.

[34]  E. Barrett-Connor,et al.  Bone mineral density thresholds for pharmacological intervention to prevent fractures. , 2004, Archives of internal medicine.

[35]  O. Johnell,et al.  Ten Year Probabilities of Osteoporotic Fractures According to BMD and Diagnostic Thresholds , 2001, Osteoporosis International.

[36]  L. Melton,et al.  Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA , 2008, Osteoporosis International.

[37]  J. Pfeilschifter,et al.  [Diagnosis and treatment of postmenopausal osteoporosis and osteoporosis in men. German Guidelines Update 2006]. , 2007, Der Orthopade.

[38]  O. Johnell,et al.  Long-Term Risk of Osteoporotic Fracture in Malmö , 2000, Osteoporosis International.