Evaluation of a hip fracture risk score for assessing elderly women: The Melton Osteoporotic Fracture (MOF) study
Evaluation of a hip fracture risk score for assessing elderly women: The Melton Osteoporotic Fracture (MOF) study
复制标题
DOI：
10.1007/s198-002-8343-6
复制
发表时间：
2002-01-01
影响因子：
4
通讯作者：
Clarke, M
中科院分区：
文献类型：
--
作者：
McGrother, CW;Donaldson, MMK;Clarke, M
在初级保健的背景下，在老年人，骨质疏松性骨折的风险评估，很少受到关注。我们的目标是开发这样一个风险评分，并评估其可行性和有效性。这是一项100%基于人群的前瞻性队列研究，在英国莱斯特郡梅尔顿·莫布雷的一家大型全科诊所对70岁及以上的女性进行了至少5年半的随访。主要结局指标为髋部骨折、死亡和移位。基线测量包括跟骨宽带超声衰减（BUA）、报告的福尔斯、平衡、既往骨折史、医疗问题、视力、足部问题、体型、生活方式因素和认知障碍。百分之七十的样本（1289）参加，包括那些在住宅区。髋部骨折超过3年的独立预测因素是低体重、脊柱后凸、足部循环不良、癫痫、短期使用类固醇和躯干运动不良。使用最高的三分位数，基于这些变量的风险评分确定了84%（95% CI：70%至98%）的髋部骨折，特异性为68%（95% CI：65%至71%）。BUA不能独立预测该年龄组女性的髋部骨折。这项研究表明，结合容易获得的风险因素，可以确定老年妇女谁将在未来3年内维持髋部骨折更准确地比骨测量单独在年轻妇女。它还表明，在初级保健环境中，采用风险评分方法对老年人进行普遍评估是一个可行的建议。
Risk assessment for osteoporotic fracture within a primary care context, in old age, has received little attention. We aimed to develop such a risk score and assess its feasibility and validity. This was a 100% population-based, prospective cohort study, with a minimum 5 1/2 year follow-up among women aged 70 years and over, set in a large single general practice in Melton Mowbray, Leicestershire, UK. The main outcome measures were hip fracture, death and migration. Baseline measures included calcaneal broadband ultrasound attenuation (BUA), reported falls, balance, previous fracture history, medical problems, visual acuity, foot problems, body size, lifestyle factors and cognitive impairment. Seventy percent of the sample (1289) participated, including those in residential accommodation. Independent predictors of hip fracture over 3 years were low weight, kyphosis, poor circulation in the foot, epilepsy, short-term use of steroids and poor trunk maneuver. Using the highest tertile, a risk score based on these variables identified 84% (95% CI: 70% to 98%) of the hip fractures with a specificity of 68% (95% CI: 65% to 71 %). BUA did not independently predict hip fracture in women of this age group. This study shows that a combination of readily obtained risk factors can identify elderly women who will sustain a hip fracture in the next 3 years more accurately than bone measurements alone in younger women. It also suggests that a risk score approach to universal assessment in the elderly is a feasible proposition in the primary care setting.