Nguyen et al evaluated older adults for risk factors associated with osteoporotic fractures. These can help identify a patient who may benefit from preventive therapy. The authors are from St. Vincent's Hospital and the University of New South Wales in Australia.
Patient selection: adult >= 60 years of age
Parameters:
(1) gender
(2) quadriceps muscle strength in dominant leg in kilograms
(3) body sway while standing on foam with eyes closed in square mm
(4) bone mineral density in the femoral neck in g per square cm
|
Parameter in Males |
Finding |
Points |
|
quadriceps muscle strength |
>= 44 kg |
0 |
|
|
34 - 43 kg |
1 |
|
|
27 - 33 kg |
2 |
|
|
<= 26 kg |
3 |
|
body sway on foam |
<= 510 square mm |
0 |
|
|
511 - 874 square mm |
1 |
|
|
875 - 1667 square mm |
2 |
|
|
>= 1668 square mm |
3 |
|
bone mineral density |
>= 1.01 g per square cm |
0 |
|
|
0.92 - 1.00 g per square cm |
1 |
|
|
0.83 - 0.91 g per square cm |
2 |
|
|
<= 0.82 g per square cm |
3 |
|
Parameter in Females |
Finding |
Points |
|
quadriceps muscle strength |
>= 25 kg |
0 |
|
|
20 - 24 kg |
1 |
|
|
15 - 19 kg |
2 |
|
|
<= 14 kg |
3 |
|
body sway on foam |
<= 378 square mm |
0 |
|
|
379 - 621 square mm |
1 |
|
|
622 - 1125 square mm |
2 |
|
|
>= 1126 square mm |
3 |
|
bone mineral density |
>= 0.88 g per square cm |
0 |
|
|
0.79 - 0.87 g per square cm |
1 |
|
|
0.71 - 0.78 g per square cm |
2 |
|
|
<= 0.70 g per square cm |
3 |
where:
• The points are based on the quartiles in each group.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• A high score is associated with a greater risk of fractures.
|
Total Score |
Percent Fractures Per Year in Males |
Percent Fractures Per Year in Females |
|
0 |
0 |
0 |
|
1 |
3.9 |
3.4 |
|
2 |
1.9 |
2.3 |
|
3 |
1.1 |
0.7 |
|
4 |
1.1 |
2.2 |
|
5 |
0.9 |
2.4 |
|
6 |
1.1 |
0.9 |
|
7 |
3.7 |
8.5 |
|
8 |
3.8 |
8.5 |
|
9 |
8.6 |
16.1 |
Simplified (the distribution in scores from 1 to 6 shows variation probably related to the small numbers in some of the categories)
|
Total Score |
Percent Fractures Per Year in Males |
Percent Fractures Per Year in Females |
|
0 |
0 |
0 |
|
1 - 6 |
1 - 2% |
1 - 3% |
|
7 - 8 |
3 - 4% |
8.5% |
|
9 |
8.6% |
16.1% |
Limitations:
• As with other osteoporotic fracture scores, the score works better in populations than it does predicting for an individual patient.
Specialty: Surgery, orthopedic, Endocrinology, Nutrition
ICD-10: ,
