Prevalence of hip fracture risk factors in women aged 70 years and over

Abstract

We estimated the prevalence of common risk factors for hip fracture and the numbers needed to treat (NNT) to prevent a hip fracture in various high-risk population groups, using a postal risk factor survey of women aged 70 years and above from General Practices in Grampian and Yorkshire. Recorded risk factors included prior fracture of any type; low body weight; smoking; and family history of fracture. The prevalence rates of hip fracture risk factors were 34%, 7% and 11% for previous fracture, maternal hip fracture and smoking, respectively for the Grampian practices (low body weight being defined as falling in the lowest quartile) and 34%, 7% and 7% for a single practice in the York area. Applying previously published estimates of risk, NNT analysis produced a value of about 300 for women with no risk factors, whilst for women with three risk factors it was between 32 and 71, depending on which risk factors were present and assuming intervention reduced fracture rates by 30% or 50%. Groups of women at high risk of hip fracture can easily be identified in primary care and offered treatment, with realistic prospects of hip fracture prevention.

Evaluation of exposure-specific risks from two independent samples: A simulation study

“…In the absence of having access to the primary data or a reported estimate of the ESR in the literature, the ESR can be estimated from two independent samples if the investigator knows the overall risk of disease and the relative risk (RR) of disease given the exposure of interest. There have been a number of published studies where ESRs have been calculated from two independent samples by multiplying the overall risk of disease from one sample by the RR from a second independent sample [1,2]. Stewart et al computed the ESR of hip fracture given certain exposures (prior fracture, family history of fracture, low body weight, and smoking) in persons over the age of 70 in the United Kingdom [2].…”

“…There have been a number of published studies where ESRs have been calculated from two independent samples by multiplying the overall risk of disease from one sample by the RR from a second independent sample [1,2]. Stewart et al computed the ESR of hip fracture given certain exposures (prior fracture, family history of fracture, low body weight, and smoking) in persons over the age of 70 in the United Kingdom [2]. This study found that the ESR of hip fracture among those with all 4 exposures was 8.9%.…”

The effect of high dose antibiotic impregnated cement on rate of surgical site infection after hip hemiarthroplasty for fractured neck of femur: a protocol for a double-blind quasi randomised controlled trial

“…With an increasingly elderly and growing population, the number of osteoporotic fractures will steadily increase over the next few decades [1]. In the UK over the next 40 years, the number of people over 60 years will rise by around 50%, and the number of those over 90 years of age will double [2].…”

A Markov model of secondary prevention of osteoportic hip fractures.

“…suggest that if strategies aimed at preventing hip fracture are to be productive, then they should be targeted at subgroups that are at an increased risk of fracture rather than the entire osteoporosis population [25]. To identify patients at high risk of hip fracture, it is necessary to know which risk factors are important and the magnitude of the fracture risk [30].…”

“…The increasing number of therapeutic options for fracture prevention require targeting towards high-risk groups if they are to be cost-effective [30]. Where health-service resources are limited, applying secondary prevention to high-risk groups may be more feasible economically than treating a less narrowly defined population [25].…”