Updated fracture incidence rates for the US version of FRAX.

Updated fracture incidence rates for the US version of FRAX.
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DOI:
10.1007/s00198-009-1032-9
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发表时间:
2010-01
影响因子:
4
通讯作者:
Melton, L. J., III
Melton, L. J., III
中科院分区:
医学2区
文献类型:
--
作者:
Ettinger, B.;Black, D. M.;Dawson-Hughes, B.;Pressman, A. R.;Melton, L. J., III

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根据更新的骨折和死亡率数据,我们建议修订美国版FRAX®中使用的基础人群值。建议的变化的影响可能是降低10年的骨折概率。对美国版FRAX®产生的结果的评估表明,该工具高估了严重骨折的可能性。为了纠正这一点,我们更新了模型的潜在骨折率和死亡率。我们使用2006年的美国出院数据计算年龄和性别特异性髋部骨折的年发生率,以及年龄特异性比率来估计临床椎骨骨折发生率。为了估计四种主要腰椎骨折中任何一种的发生率,我们首先将这些新得出的髋部和椎骨骨折估计值与明尼苏达州奥姆斯特德县的腕部和肱骨上部骨折率相加,然后对重叠部分进行10-20%的折扣。与当前FRAX®工具中使用的比率相比,2006年髋部骨折率降低约16%,在65岁以下的人群中观察到的降幅最大;严重骨质疏松性骨折率降低约四分之一,所有年龄段的降幅相似。我们建议通过更新当前髋部骨折和严重骨质疏松性骨折的基础人群值来修订US-FRAX。这些修订对FRAX®的影响可能是降低10年骨折概率,但在这些新的发生率被纳入FRAX®工具后,将可以更精确地估计这些变化的影响。
On the basis of updated fracture and mortality data, we recommend that the base population values used in the US version of FRAX® be revised. The impact of suggested changes is likely to be a lowering of 10-year fracture probabilities. Evaluation of results produced by the US version of FRAX® indicates that this tool overestimates the likelihood of major osteoporotic fracture. In an attempt to correct this, we updated underlying fracture and mortality rates for the model. We used US hospital discharge data from 2006 to calculate annual age- and sex-specific hip fracture rates and age-specific ratios to estimate clinical vertebral fracture rates. To estimate the incidence of any one of four major osteoporotic fractures, we first summed these newly derived hip and vertebral fracture estimates with Olmsted County, MN, wrist and upper humerus fracture rates, and then applied 10–20% discounts for overlap. Compared with rates used in the current FRAX® tool, 2006 hip fracture rates are about 16% lower, with greatest reductions observed among those below age 65 years; major osteoporotic fracture rates are about one quarter lower, with similar reductions across all ages. We recommend revising the US-FRAX by updating current base population values for hip fracture and major osteoporotic fracture. The impact of these revisions on FRAX® is likely to be lowering of 10-year fracture probabilities, but more precise estimates of the impact of these changes will be available after these new rates are incorporated into the FRAX® tool.
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