OBJECTIVE: We examined a two-step case-finding strategy where the Cummings' risk score (NEJM 1995) was applied in a population-based setting together with bone mineral density (BMD) measurements in order to validate its ability to identify women with high risk of hip fracture. METHODS: All Tromsø women aged between 65 and 74 were invited to the Tromsø Osteoporosis Study (TROST) together with a 5% random sample of women aged 75-84 years (n = 1410). All had forearm BMD measurements in 1994/95 and were followed for 5 years with respect to first hip fracture. A risk score was constructed matching the Cummings score as closely as possible. RESULTS: In all 759, 578 and 73 women had 0-2, 3-4 and 5+ risk factors, respectively. Women with 5+ risk factors had a 5-year hip fracture risk of 11% (95% confidence interval (CI) 3.7-18.2%). BMD screening applied to these women identified 74% of them as osteoporotic and 19% as osteopenic with, respectively, 5-year hip fracture risk of 13% and 7.1%. CONCLUSION: In a population different from the one the score was generated in, this simple risk score identifies a group of women with high risk of hip fractures. With no additional BMD measurements, those high-risk women could benefit from early intervention measures.
OBJECTIVE: We examined a two-step case-finding strategy where the Cummings' risk score (NEJM 1995) was applied in a population-based setting together with bone mineral density (BMD) measurements in order to validate its ability to identify women with high risk of hip fracture. METHODS: All Tromsø women aged between 65 and 74 were invited to the Tromsø Osteoporosis Study (TROST) together with a 5% random sample of women aged 75-84 years (n = 1410). All had forearm BMD measurements in 1994/95 and were followed for 5 years with respect to first hip fracture. A risk score was constructed matching the Cummings score as closely as possible. RESULTS: In all 759, 578 and 73 women had 0-2, 3-4 and 5+ risk factors, respectively. Women with 5+ risk factors had a 5-year hip fracture risk of 11% (95% confidence interval (CI) 3.7-18.2%). BMD screening applied to these women identified 74% of them as osteoporotic and 19% as osteopenic with, respectively, 5-year hip fracture risk of 13% and 7.1%. CONCLUSION: In a population different from the one the score was generated in, this simple risk score identifies a group of women with high risk of hip fractures. With no additional BMD measurements, those high-risk women could benefit from early intervention measures.
Authors: D M Black; M Steinbuch; L Palermo; P Dargent-Molina; R Lindsay; M S Hoseyni; O Johnell Journal: Osteoporos Int Date: 2001 Impact factor: 4.507
Authors: S R Cummings; D M Black; M C Nevitt; W Browner; J Cauley; K Ensrud; H K Genant; L Palermo; J Scott; T M Vogt Journal: Lancet Date: 1993-01-09 Impact factor: 79.321
Authors: John A Kanis; Olof Johnell; Dennis M Black; Robert W Downs; Somnath Sarkar; Thomas Fuerst; Roberta J Secrest; Imre Pavo Journal: Bone Date: 2003-09 Impact factor: 4.398
Authors: Paul D Miller; Suna Barlas; Susan K Brenneman; Thomas A Abbott; Ya-Ting Chen; Elizabeth Barrett-Connor; Ethel S Siris Journal: Arch Intern Med Date: 2004-05-24