Hip Fracture, Fragility Fracture, or Death Within 2 Years, Predicted by 2 to 4 vs 0 to 1 Risk Factors, According to Risk Model
Total Population (N = 1,248) | |||||||||
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Risk Model | Total N | Events n | No Events n | NPV/PPV (%) | Specificity/Sensitivity (%) | Odds Ratio (95% CI) | P Exact | Vislanda (n = 435)P Exact | Tingsryd & Emmaboda (n = 418& 395)P Exact |
NPV = negative predictive value; PPV = positive predictive value; CI = confidence interval; FRAMO = Fracture and Mortality. | |||||||||
Note: Hypothesis tested by the Fisher exact test. Risk model 1 (FRAMO Index): age =80 years, weight <60 kg, previous fragility fracture, and using arms when rising at least 5 times from sitting position.*† Risk model 2: age =80 years, weight <60 kg, previous fragility fracture, and falls during the past 12 months. Women with missing data were recoded as having a low fracture risk; therefore, data for all 1,248 women were included in the Fisher exact 2-sided test and the binary logistic regression analysis. | |||||||||
* Previous fragility fractures: fractures in the hip, lower arm, upper arm, or vertebrae after age 40 years. | |||||||||
† Included reported vertebral fractures from responses to the radiograph question in the Vislanda population. | |||||||||
‡ P <.001. | |||||||||
§ P <.01. | |||||||||
|| Fragility fractures: fractures of the hip, distal radius, proximal humerus, pubic bone, ischial bone, or vertebrae during 2002–2003. ¶ Data for all types of fragility fractures were obtained only for the Vislanda and Tingsryd populations (n = 853). | |||||||||
# P <.05. | |||||||||
Risk model 1 (FRAMO Index): Age, weight, previous fragility fracture,*† and using arms to rise | |||||||||
Hip fractures | |||||||||
0–1 risk factor | 789 | 6 | 783 | 99.2/5.4 | 64/81 | 1.0 | <.001‡ | <.001‡ | .002§ |
2–4 risk factors | 459 | 25 | 434 | 7.5 (3.0–18.4)‡ | |||||
Fragility fractures||,¶ | |||||||||
0–1 risk factor | 547 | 9 | 538 | 98.4/10.0 | 66/78 | 1.0 | <.001‡ | <.001‡ | .001§ |
2–4 risk factors | 306 | 31 | 275 | 6.7 (3.2–14.3)‡ | |||||
Mortality | |||||||||
0–1 risk factor | 789 | 25 | 764 | 96.8/24.0 | 67/81 | 1.0 | <.001‡ | <.001‡ | <.001‡ |
2–4 risk factors | 459 | 109 | 350 | 9.5 (6.0–14.9)‡ | |||||
Risk model 2: Age, weight, previous fragility fracture,*† and fall | |||||||||
Hip fractures | |||||||||
0–1 risk factor | 775 | 9 | 766 | 98.8/4.7 | 63/71 | 1.0 | <.001‡ | .001§ | .052 |
2–4 risk factors | 473 | 22 | 451 | 4.1 (1.9–9.1)‡ | |||||
Fragility fractures||,¶ | |||||||||
0–1 risk factor | 537 | 12 | 525 | 97.8/8.9 | 65/70 | 1.0 | <.001‡ | <.001‡ | .04# |
2–4 risk factors | 316 | 28 | 288 | 4.2 (2.1–8.5)‡ | |||||
Mortality | |||||||||
0–1 risk factor | 775 | 35 | 740 | 95.5/21.0 | 66/74 | <.001‡ | <.001‡ | <.001‡ | |
2–4 risk factors | 473 | 99 | 374 | 5.6 (3.7–8.4)‡ |