Calcified Tissue International

, Volume 92, Issue 5, pp 429–436 | Cite as

Incidence of Hip Fracture in Romania and the Development of a Romanian FRAX Model

  • Daniel GrigorieEmail author
  • Alina Sucaliuc
  • Helena Johansson
  • John A. Kanis
  • Eugene McCloskey
Original Research


A FRAX® model for Romania calibrated to the total Romanian population was released June 1, 2011. This article describes the data used to develop the Romanian FRAX model and illustrates its features compared to models for other countries. Age- and sex-stratified hip fracture incidence rates and mortality rates for 2010 were extracted from nationwide databases from the age of 40 years. For other major fractures, Romanian incidence rates were imputed, using Swedish ratios for hip to other major osteoporotic fracture (humerus, forearm, and clinically symptomatic vertebral fractures). Fracture incidence rates increased with increasing age: for hip fracture, incidence rates were higher among younger men than women but with a female preponderance from the age of 65 years. The 10-year probability of hip or major fracture was increased in patients with a clinical risk factor (CRF), lower BMI, female gender, higher age, and decreased BMD T score. Of the CRFs, a parental hip fracture accounted for the greatest increase in 10-year fracture probability. The Romanian FRAX tool is the first country-specific fracture prediction model. It is based on the original FRAX methodology, which has been externally validated in several independent cohorts. Despite some limitations, the strengths make the Romanian FRAX tool a good candidate for implementation into clinical practice.


FRAX 10-year fracture probability Hip fracture Osteoporotic fracture Osteoporosis 



We are grateful to Professor C. Vladescu, director of the National School of Public Health, Bucharest, for assistance in gathering data on hip fractures.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Daniel Grigorie
    • 1
    Email author
  • Alina Sucaliuc
    • 1
  • Helena Johansson
    • 2
  • John A. Kanis
    • 2
  • Eugene McCloskey
    • 2
  1. 1.Carol Davila University of Medicine, National Institute of EndocrinologyBucharestRomania
  2. 2.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK

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