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FRAX

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Senior Trauma Patients

Abstract

The introduction of the FRAX® algorithms has facilitated the assessment of fracture risk on the basis of fracture probability. FRAX integrates the influence of several well-validated risk factors for fracture with or without the use of BMD. Since age-specific rates of fracture and death differ across the world, all FRAX models are calibrated with regard to the epidemiology of hip fracture (preferably from national sources) and mortality (usually UN source). Models are currently available for 78 nations or territories covering more than 80% of the world population. FRAX has been incorporated into more than 80 guidelines worldwide, although the nature of this application has been heterogeneous. The limitations of FRAX have been extensively reviewed. Relatively simple arithmetic procedures have been proposed, in order to address some of these limitations, which can be applied to conventional FRAX estimates to accommodate knowledge of: dose exposure to glucocorticoids; concurrent data on lumbar spine BMD; information on trabecular bone score (TBS); hip axis length; falls history; type 2 diabetes; immigration status; and recency of prior fracture.

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Acknowledgements

Some text is reproduced from Kanis JA, Cooper C, Rizzoli R, Reginster J-Y; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO); and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF) (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International 30: 3-44; Kanis JA, Harvey NC, Johansson H, Odén A, Leslie WD McCloskey EV (2017) FRAX update. Journal of Clinical Densitometry. 20: 360–367.

Author information

Authors and Affiliations

  1. Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Broomhall, Sheffield, UK

    John A. Kanis, Helena Johansson & Eugene V. McCloskey

  2. Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia

    John A. Kanis, Helena Johansson & Enwu Liu

  3. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    Nicholas C. Harvey

  4. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Nicholas C. Harvey

  5. Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden

    Helena Johansson

  6. Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden

    Mattias Lorentzon

  7. Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, Mölndal, Sweden

    Mattias Lorentzon

  8. University of Manitoba, Winnipeg, Canada

    William D. Leslie

  9. Centre for Integrated research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK

    Eugene V. McCloskey

Authors
  1. John A. Kanis
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  2. Nicholas C. Harvey
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  3. Helena Johansson
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  4. Mattias Lorentzon
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  5. Enwu Liu
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  6. William D. Leslie
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  7. Eugene V. McCloskey
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Correspondence to John A. Kanis .

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Editors and Affiliations

  1. Department of Trauma Surgery, University Hospital Zurich, Zürich, Switzerland

    Hans-Christoph Pape

  2. Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA, USA

    Stephen L. Kates

  3. Department of Trauma Surgery, University Hospital Zurich, Zürich, Switzerland

    Christian Hierholzer

  4. Department of Aging Medicine and Aging Research, City Hospital Zurich-Waid Zurich University, Zürich, Switzerland

    Heike A. Bischoff-Ferrari

Ethics declarations

Professor Kanis led the team that developed FRAX as director of the WHO Collaborating Centre for Metabolic Bone Diseases; he has no financial interest in FRAX. Professors McCloskey, Harvey, and Dr. Johansson are members of the FRAX team. Professors Kanis, Harvey, and McCloskey are members of the advisory body of the National Osteoporosis Guideline Group, UK. William D Leslie declares no competing interests.

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Kanis, J.A. et al. (2022). FRAX. In: Pape, HC., Kates, S.L., Hierholzer, C., Bischoff-Ferrari, H.A. (eds) Senior Trauma Patients . Springer, Cham. https://doi.org/10.1007/978-3-030-91483-7_10

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