Osteoporosis International

, Volume 12, Issue 12, pp 989–995

Ten Year Probabilities of Osteoporotic Fractures According to BMD and Diagnostic Thresholds

Authors

  • J. A. Kanis
    • WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
  • O. Johnell
    • Department of Orthopaedics, Malmo¨ General Hospital, Malmo¨
  • A. Oden
    • Consulting Statistician, Gothenberg, Sweden
  • A. Dawson
    • Lilly Research Centre Ltd, Windlesham, UK
  • C. De Laet
    • Institute for Medical Technology Assessment, Rotterdam, The Netherlands;
  • B. Jonsson
    • Department of Economics, Stockholm School of Economics, Stockholm, Sweden
Original Article

DOI: 10.1007/s001980170006

Cite this article as:
Kanis, J., Johnell, O., Oden, A. et al. Osteoporos Int (2001) 12: 989. doi:10.1007/s001980170006

Abstract:

The objectives of the present study were to estimate 10 year probabilities of osteoporotic fractures in men and women according to age and bone mineral density (BMD) at the femoral neck. Risks were computed from the incidence of a first hip, distal forearm, proximal humerus and symptomatic vertebral fracture from patient records in Malmo¨, Sweden and future mortality rates for each year of age from Poisson models using the Swedish patient register and statistical year book. Fracture probability was computed using the Swedish population and cut-off values for T-scores based on the NHANES III female population. We assumed that the risk of fracture increased with decreasing BMD as assessed by meta-analysis in independent studies. The 10-year probability of any fracture was determined from the proportion of individuals fracture-free from the age of 45 years. With the exception of forearm fractures in men, 10 year probabilities increased with age and T-score. In the case of hip and spine fractures, fracture probabilities for any age with low BMD were similar between men and women. The effect of age on risk independently of BMD suggests that intervention thresholds should not be at a fixed T-score but vary according to absolute probabilities. Intervention thresholds based on hip BMD T-scores are similar between sexes.

Key words:Absolute risk – Colles’ fracture – Hip fracture – Humeral fracture – Intervention thresholds – Osteoporotic fracture – Vertebral fracture

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2001