This study aimed to identify fracture risk in an outpatient population using FRAX without BMD measurements. Researchers assessed 50 patients over 50 for clinical risk factors and calculated 10-year fracture risk. Nearly 60% of patients were found to be at intermediate or high risk of fracture warranting further investigation or treatment. The population was predominantly male, of median age 64, and in the overweight BMI category. The study highlights the opportunity for outpatient clinics to help reduce fracture risk, morbidity, mortality and healthcare costs by systematically identifying at-risk patients.

1. USE OF FRAX® WITHOUT BMD TO ASSESS
RISK OF FRACTURE IN AN OUT-PATIENT POPULATION
Clifford, G.T., Slattery, C., van der Kamp, S., McKenna, M.
Background
• Fractures place a significant burden on the
patient, the hospital and the healthcare
system in terms of cost, morbidity,
mortality. Each year there are 3000 hospital
admissions due to hip fracture (IHFD
2013). Hospital out-patient departments, as
major healthcare providers to its local
catchment area have an opportunity to be
at the forefront of identifying risk of fracture
among its patients.
• FRAX® has been recommended by WHO
for use in identifying patients at risk of
fracture and has been validated in a
number of populations and healthcare
settings.
Correspondence: gareth.clifford@svuh.ie
17
22
7
0
5
10
15
20
25
Low Intermediate High
Risk of Fracture
Low
Intermediate
High
2 5 5
12 9 7 9 8
44
39 40
32
37 38 37 38
0
10
20
30
40
50
Osteoporosis Risk Factors
Yes
No
Don't Know
• Nearly 60% of patients warranted
investigation and/or treatment for
osteoporosis.
Aim
• To identify the risk of fracture in an out-
patient population and to determine who
would benefit from osteoporosis treatment.
Methodology
• All patients over 50 years were considered
for inclusion for this cross-sectional study.
• A convenience sample of 50 patients was
selected from an IV Therapies Suite.
• FRAX® without BMD using clinical risk
factors, age and BMI was used to
determine risk of fracture.
• Data collection included: age, body mass
index, current bone protection medications,
previous fragility fractures, parental history
of hip fracture, current glucocorticoid use,
current smoker and current alcohol use.
• Descriptive statistics were used.
Results
• Of the 50 participants, there were 31
males, the median age was 64 years and
the median BMI was 27 kg/m2. Nineteen
patients were on Vitamin D or calcium
supplements. No patients were on bone
protection despite 5 patients with a prior
fragility fracture.
Conclusion
• This was an younger, predominately male
population in the overweight BMI category.
• Patients require a comprehensive
assessment of both risk of fracture and risk
of falling to prevent a harmful fall. The risk
factors for both fracture and falls are not
interchangeable.
• Identifying risk of fracture, and subsequent
investigation and/or treatment could
significantly reduce the risk of fracture and
thereby, morbidity, mortality and cost.
14
20
5
0
1
2
0
5
10
15
20
25
Low Intermediate High
Falls v Risk of Fracture
≥2
1
0