Development of Simple Assessment tool for predict imminent risk of Fracture in Elderly women

Abstract

Background/Aims: Previously developed fracture risk prediction models primarily estimate long-term risk and are limited in their ability to predict imminent fractures. We developed a simplified and practical model to predict the short-term fracture risk (1-to 3-year risk) in elderly Korean women. Methods: We included 1,440,988 women who underwent a national life-transition health examination at age 66 between 2011 and 2017. The participants were followed-up for 3 years to identify major osteoporotic fractures (MOFs) and hip fractures. Clinical risk factors such as body mass index, bone mineral density, fall history within 6 months, prior fractures within 3 years, recent fractures within 1 year, and recurrent fractures were analyzed. Multivariate logistic regression was used to estimate the odds ratios (ORs) for these risk factors. Each OR was converted into a risk score, and the total scores were stratified into five groups: 0-4, 5-7, 8-10, 11-14, and 15-18 points. Results: Higher scores were associated with a significantly increased risk of fractures. At 3 years, the incidences of MOF were 3.4%, 5.8%, 12.0%, 21.3%, and 36.6%, and the hip fracture incidences were 0.13%, 0.26%, 0.59%, 0.73%, and 1.82% across the five groups, respectively. Conclusions: This simplified scoring model is a practical tool for predicting the 1-to 3-year fracture risk in elderly Korean women. By stratifying patients into risk groups based on routine clinical data, it enables the early identification of high-risk individuals and facilitates timely preventive care.