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Hip and fragility f...
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Albertsson, Daniel M,1957Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,University of Gothenburg, Sweden;Region Kronoberg, Sweden
(författare)
Hip and fragility fracture prediction by 4-item clinical risk score and mobile heel BMD: a women cohort study
- Artikel/kapitelEngelska2010
Förlag, utgivningsår, omfång ...
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2010-03-24
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Springer Science and Business Media LLC,2010
Nummerbeteckningar
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LIBRIS-ID:oai:gup.ub.gu.se/133832
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https://gup.ub.gu.se/publication/133832URI
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https://doi.org/10.1186/1471-2474-11-55DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-81241URI
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Ämneskategori:art swepub-publicationtype
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Background One in four Swedish women suffers a hip fracture yielding high morbidity and mortality. We wanted to revalidate a 4-item clinical risk score and evaluate a portable heel bone mineral density (BMD) technique regarding hip and fragility fracture risk among elderly women. Methods In a population-based prospective cohort study we used clinical risk factors from a baseline questionnaire and heel BMD to predict a two-year hip and fragility fracture outcome for women, in a fracture preventive program. Calcaneal heel BMD was measured by portable dual X-ray laser absorptiometry (DXL) and compared to hip BMD, measured with stationary dual X-ray absorptiometry (DXA) technique. Results Seven women suffered hip fracture and 14 women fragility fracture/s (at hip, radius, humerus and pelvis) among 285 women; 60% having heel BMD ≤ -2.5 SD. The 4-item FRAMO (Fracture and Mortality) Index combined the clinical risk factors age ≥80 years, weight <60 kg, prior fragility fracture, and impaired rise-up ability. Women having 2-4 risk factors showed odds ratio (OR) for hip fracture of 5.9 and fragility fracture of 4.4. High risk group hip fracture risk was 2.8% annually compared to 0.5% for the low risk majority (69%). Heel BMD showed hip fracture OR of 3.1 and fragility fracture OR of 2.6 per SD decrease. For 30 DXA assessed participants mean hip BMD at -2.5 SD level corresponded to a lower BMD at the heel. Five of seven hip fractures occurred within a small risk group of 32 women, identified by high FRAMO Index + prior fragility fracture + heel T-score ≤-3.5 SD. Conclusions In a follow-up study we identified high risk groups for hip and fragility fracture with our plain 4-item risk model. Increased fracture risk was also related to decreasing heel BMD in calcaneal bone, measured with a mobile DXL technique. A combination of high FRAMO Index, prior fragility fracture, and very low BMD restricted the high risk group to 11%, among whom most hip fractures occurred (71%). These practical screening methods could eventually reduce hip fracture incidence by concentrating preventive resources to high fracture risk women.
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Mellström, Dan,1945Sahlgrenska University Hospital, Sweden(Swepub:gu)xmelda
(författare)
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Petersson, ChristerRegion Kronoberg, Sweden
(författare)
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Thulesius, HansRegion Kronoberg, Sweden(Swepub:lnu)hnthab
(författare)
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Eggertsen, Robert,1948Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,University of Gothenburg, Sweden;Mölnlycke Primary Hlth Care & Res Ctr, Sweden(Swepub:gu)xeggro
(författare)
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Göteborgs universitetInstitutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:BMC Musculosceletal disorders: Springer Science and Business Media LLC111471-2474
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