The questionnaire identifies those who are at risk of a fracture
According to a new study, screening in the form of a simple questionnaire in combination with densitometry (measurement of bone mineral density using X-ray or ultrasound) allows you to identify women at risk of hip fracture.
The study involved more than 12,000 elderly women who, according to the results of the survey, were offered treatment if there were indications. Among women who agreed, the risk of hip fracture decreased by 28% within five years.
The authors have demonstrated not only the clinical effectiveness of screening, but also its economic advantages – studies of the cost-effectiveness ratio have shown very attractive results.
Approximately one in three women and one in five men over the age of 50 suffer from pathological fractures during later life, that is, fractures associated with destructive processes in the bones. In the UK, 536,000 people go to doctors every year for fractures associated with increased bone fragility, including 79,000 with a hip fracture.
The consequences of a hip fracture for the elderly can be the most disappointing: from the need for surgical treatment to loss of mobility and independence in self-care. Mortality within one year after the fracture is 20%.
A group of researchers from the University of Sheffield (UK) has developed a FRAX questionnaire that automatically calculates the probability of a femoral fracture or a major osteoporotic fracture (hip, spine, shoulder or forearm bones) to identify people at risk.
The study involved 12,483 women aged 70-85 years. Half of the participants were screened to compare its results with a standard examination.
Among the women who underwent screening, one in seven women was assigned to the high-risk group of hip fracture. Each of them was recommended treatment for osteoporosis, approximately 75% of them received it within the next six months.
The use of screening did not reduce the total number of fractures, nor did it affect mortality rates and quality of life. But the frequency of hip fractures decreased: there were 54 fewer cases in the screening group than in the standard examination group.
Data analysis showed that screening avoids 1 fracture case for every 111 women examined. From an economic point of view, the authors find this approach effective.
Given the fact that hip fracture treatment is expensive for the state, the introduction of FRAX screening will undoubtedly have important public health implications.
Article by Lee Shepstone et al. Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial published in The Lancet.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru based on the materials of the University of Birmingham: Screening could prevent a quarter of hip fractures in older women.