The association of FRAX with predictors of falls in the assessment of postmenopausal osteoporosis in Turkey: the fracture study of Turkey (FRACT study)

IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Archives of Osteoporosis Pub Date : 2024-04-20 DOI:10.1007/s11657-024-01387-2
Sansin Tuzun, Ulku Akarirmak, Bilal Kulaksiz, Aslinur Keles, Dilara Okutan, Pinar Karsli, Sevgi Selin Kurtoglu, Eren Aygun, Deniz Palamar
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Abstract

Summary

Although FRAX is used for fracture risk evaluation, this tool does not include balance and fall risk. The association between the predictors of falls and high FRAX scores we found in this study suggests that risk indicators for falls may add substantial value to FRAX by improving fracture risk prediction.

Purpose

This observational, descriptive, and cross-sectional study aimed to assess the fall risk predictors and explore their association with FRAX in Turkish patients with postmenopausal osteoporosis.

Methods

Two hundred and nine (209) women with postmenopausal osteoporosis referred to the Fracture Liaison Service (FLS) at Istanbul University–Cerrahpaşa were enrolled in the FRACT study (The Fracture Study of Turkey). Clinical risk factors were assessed using the FRAX tool. Tandem stance, Tandem walking, Timed up and go (TUG), and Chair stand tests were performed to assess balance and fall risk.

Results

Among patients with a mean age of 67.6 (± 9.7) years, 66 patients (31.6%) had osteoporosis without fractures and 143 patients (68.4%) had fragility fractures. The proportion of patients with poor performance of fall prediction tests was significantly higher in patients with a fragility fracture than those with osteoporosis alone. There was an inverse relationship between dynamic balance tests and the reported number of prior falls in the past year. FRAX score was higher in patients with impaired Tandem stance, Tandem walking, and TUG tests (p = 0.008, p = 0.035, p = 0.001, respectively).

Conclusion

Assessment of fall risk predictors should be one of the major pillars in the physical evaluation of osteoporotic patients in the FLS setting. FRAX is a useful tool to determine the fracture risk of patients with both static and dynamic balance impairments. Combining balance assessment with FRAX may be an important step to optimize osteoporosis risk assessment.

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土耳其绝经后骨质疏松症评估中 FRAX 与跌倒预测因素的关联:土耳其骨折研究(FRACT 研究)
摘要虽然 FRAX 用于骨折风险评估,但该工具并不包括平衡和跌倒风险。我们在本研究中发现的跌倒预测因素与 FRAX 高分之间的关联表明,跌倒风险指标可通过改善骨折风险预测为 FRAX 带来巨大价值。方法伊斯坦布尔大学-切拉帕萨分校骨折联络服务处(FLS)转诊的 29(209)名绝经后骨质疏松症女性参加了 FRACT 研究(土耳其骨折研究)。临床风险因素采用 FRAX 工具进行评估。结果在平均年龄为 67.6 (± 9.7) 岁的患者中,有 66 名患者(31.6%)患有骨质疏松症但没有骨折,143 名患者(68.4%)患有脆性骨折。在脆性骨折患者中,跌倒预测测试表现不佳的患者比例明显高于单纯骨质疏松症患者。动态平衡测试与报告的过去一年中跌倒的次数呈反比关系。在 Tandem stance、Tandem walking 和 TUG 测试受损的患者中,FRAX 得分更高(分别为 p = 0.008、p = 0.035、p = 0.001)。FRAX 是确定静态和动态平衡障碍患者骨折风险的有效工具。将平衡评估与 FRAX 结合起来可能是优化骨质疏松症风险评估的一个重要步骤。
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来源期刊
Archives of Osteoporosis
Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS
CiteScore
5.50
自引率
10.00%
发文量
133
期刊介绍: Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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