Korean J Bone Metab > Volume 18(1); 2011 > Article
Korean Journal of Bone Metabolism 2011;18(1):15-21.
분당서울대병원
Osteoporosis Medication Treatment Thresholds for Patients with a Distal Radius Fracture as Determined using Bone Mineral Density and the Fracture Risk Assessment Tool
박재우,허정규,김준엽,오주한,백구현,공현식
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.
Key Words: Bone Density, Distal radius fracture, Fracture risk assessment tool, Osteoporosis
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