DEVELOPMENT OF SIMPLE ASSESSMENT TOOL FOR FRACTURE ESTIMATION IN KOREAN ELDERLY WOMEN (SAFE) TO PREDICT IMMINENT RISK OF FRACTURES IN KOREAN ELDERLY WOMEN

초록

Objective: Previously developed fracture risk prediction models have limitations in applying them to clinical practice. In this study, we developed more simplified and convenient fracture risk prediction model in Korean elderly women. Methods: A total of 1,440,988 women who underwent 66-year-old life changing national examination in 2011–2017 were included and followed for 3 y. Incidence of major osteoporotic fracture (MOF) and hip fracture in 1 y or 3 y were analyzed. Clinical risk factors such as age, BMI, BMD, history of fall within 6 months, past fracture within 3 y, recent fracture within 1 y, and recurrent fracture were collected. Multivariate logistic regression analysis was used to calculate the odds ratio (OR) of each risk factor for osteoporotic fracture. A new fracture prediction score for MOF and hip fracture was developed; Simple Assessment tool for Fracture Estimation, SAFE. Results: Scores were calculated using the OR of each risk factor for osteoporotic fracture According to the sum of the scores, it was classified into 6 groups; 0–3, 4–6, 7–9, 10–12, 13–15, and 16–18 score. The higher the score, the higher the risk of 1-y and 3-y MOF and hip fracture. The 3-y MOF and hip fracture was 5% and 0.2% (0–3 score), 5% and 0.2% (4–6 score), 9% and 0.4% in 7–9 score, 17% and 0.8% in 10–12 score, 30% and 0.8% in 13–15 score, 35% and 2.2% in 16–18 score. The 1-y MOF and hip fracture was 2% and 0% (0–3 score), 2% and 0.1% (4–6 score), 4% and 0.2% in 7–9 score, 8% and 0.3% in 10–12 score, 13% and 0.4% in 13–15 score, 16% and 0.8% in 16–18 score. Conclusion: SAFE can predict well the imminent fracture risks, which could happen within 1 or 3 y.