Development of prognostic nomograms for individualizing 5-year and 10-year fracture risks
Development of prognostic nomograms for individualizing 5-year and 10-year fracture risks
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DOI：
10.1007/s00198-008-0588-0
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发表时间：
2008-10-01
影响因子：
4
通讯作者：
Nguyen, T. V.
中科院分区：
文献类型：
--
作者：
Nguyen, N. D.;Frost, S. A.;Nguyen, T. V.
我们开发了临床列线图，用于预测任何老年男性或女性 5 年和 10 年的骨折风险。列线图使用了年龄和有关骨折史、跌倒史和 BMD T 评分或体重的信息。 引言 尽管已经确定了许多骨折危险因素，但将这些危险因素转化为可用于初级保健环境的预后模型尚未得到很好的实现。本研究旨在开发一种列线图，其中包含非侵入性风险因素，以预测男性和女性个体 5 年和 10 年的绝对骨折风险。方法 Dubbo 骨质疏松症流行病学研究被设计为一项基于社区的前瞻性研究，截至 1989 年，有 1358 名 60 岁以上女性和 858 名男性参与。基线测量包括股骨颈骨矿物质密度 (FNBMD)、之前 骨折、跌倒史和体重。 1989 年至 2004 年间，有 426 名女性和 149 名男性遭受了低创伤性骨折（不包括形态测量椎骨骨折）。考虑了基于 Cox 比例风险分析的两种预后模型：模型 I 包括年龄、BMD、既往骨折和跌倒；结果 受试者工作特征曲线下面积（AUC）分析表明，模型 I（男女 AUC = 0.75）表现优于模型 II（女性 AUC = 0.72，男性 AUC = 0.74）。利用模型的估计，我们构建了各种列线图，以个体化男性和女性的骨折风险。如果 10% 或更高的 5 年风险被视为“高风险”，那么几乎所有具有 BMD T 分数的 80 岁男性
We have developed clinical nomograms for predicting 5-year and 10-year fracture risks for any elderly man or woman. The nomograms used age and information concerning fracture history, fall history, and BMD T-score or body weight.Introduction Although many fracture risk factors have been identified, the translation of these risk factors into a prognostic model that can be used in primary care setting has not been well realized. The present study sought to develop a nomogram that incorporates non-invasive risk factors to predict 5-year and 10-year absolute fracture risks for an individual man and woman.Methods The Dubbo Osteoporosis Epidemiology Study was designed as a community-based prospective study, with 1358 women and 858 men aged 60+ years as at 1989. Baseline measurements included femoral neck bone mineral density (FNBMD), prior fracture, a history of falls and body weight. Between 1989 and 2004, 426 women and 149 men had sustained a low-trauma fracture (not including morphometric vertebral fractures). Two prognostic models based on the Cox's proportional hazards analysis were considered: model I included age, BMD, prior fracture and falls; and model II included age, weight, prior fracture and fall.Results Analysis of the area under the receiver operating characteristic curve (AUC) suggested that model I (AUC = 0.75 for both sexes) performed better than model II (AUC = 0.72 for women and 0.74 for men). Using the models' estimates, we constructred various nomograms for individualizing the risk of fracture for men and women. If the 5-year risk of 10% or greater is considered "high risk", then virtually all 80-year-old men with BMD T-scores