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Incidence of fractures in women in the post-menopause: a cohort study in primary care in southern Brazil

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Abstract

Summary

The incidences of total fracture, major fracture, and hip fractures in primary care in Southern Brazil were 22.3, 15.0, and 3.3 per 1000 person/year. The FRAX algorithm showed an adequate discriminatory capacity for the identification of these fractures.

Obejective

Few studies are evaluating the incidence of fractures in Latin America and Brazil. This study aimed to estimate the incidence of bone fractures in postmenopausal women seen in primary care and evaluate the FRAX algorithm’s performance in these women.

Methods

A cohort study was carried out in the municipality of Santa Maria, Southern Brazil. Postmenopausal women aged 55 years and over who attended primary health care were included. The recruitment period was from March 1 to August 31, 2013, and the participants were followed for 5 years. The fracture risk was calculated using the FRAX algorithm. The reported incident fractures were confirmed by imaging studies or surgical reports.

Results

Of the 1057 women recruited for the study, 854 were followed. They contributed to 2732 person/year. The mean follow-up time was 3.2 years (SD 1.05). The incidences of total fractures, major fractures, and hip fractures were 22.3, 15.0, and 3.3 per 1000 person/year. The most frequent fracture sites were the wrist, shoulder, and ribs. The fracture predictors were rheumatoid arthritis, previous fracture, and the use of glucocorticoids. The discriminatory capacity of incident fractures calculated by FRAX without the inclusion of BMD was AUC 0.730 (95% CI 0.570, 0.890) for hip fracture and AUC 0.691 (95% CI 0.598, 0.784) for major fractures.

Conclusion

The FRAX algorithm showed an adequate discriminatory capacity to identify incident fractures in primary care in our study. The incidence of fractures found in our study appears to be lower than that reported in North America and Europe.

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Data availability

The study spreadsheets will be made available upon request.

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Funding

This study was funded by grants from the Federal University of Santa Maria (edital FIPE/CCS 2013) and from the Conselho Nacional de Desenvolvimento Cientifico e Tecnológico—CNPq (472211/2013–7 and 307057/2013–5). The funding sources had no role in the design, conduct, or analysis of our study or in the decision to submit this manuscript for publication.

Author information

Authors and Affiliations

  1. Department of Clinical Medicine, Federal University of Santa Maria, Santa Maria, Brazil

    Rafaela Martinez Copês & Nayara Silveira Barrios

  2. Department of Clinical Medicine, Medical School, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190 – sala 246, Belo Horizonte, MG, Brazil

    Fabio Vasconcellos Comim & Melissa Orlandin Premaor

Authors
  1. Rafaela Martinez Copês
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  2. Fabio Vasconcellos Comim
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  3. Nayara Silveira Barrios
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  4. Melissa Orlandin Premaor
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Contributions

All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. Drª Premaor had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Melissa Orlandin Premaor.

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Ethics approval

Approval for this study was obtained from the Federal University of Santa Maria Ethics Committee [Comitê de Ética em Pesquisa da UFSM (CEP – UFSM); CAAE 04320312.2.0000.5346] and from the Municipality of Santa Maria City [Núcleo de Educação Permanente em Saúde (Ofício 492/2012/SMS/NEPeS) da Secretaria de Saúde da prefeitura de Santa Maria].

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Copês, R.M., Comim, F.V., Barrios, N.S. et al. Incidence of fractures in women in the post-menopause: a cohort study in primary care in southern Brazil. Arch Osteoporos 16, 126 (2021). https://doi.org/10.1007/s11657-021-00972-z

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