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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/20634

Title: The Epidemiology of Hip and Major Osteoporotic Fractures in a Dutch Population of Community-Dwelling Elderly: Implications for the Dutch FRAX (R) Algorithm
Authors: Klop, Corinne
Welsing, Paco M. J.
Leufkens, Hubert G. M.
Elders, Petra J. M.
Overbeek, Jetty A.
van den Bergh, Joop
Bijlsma, Johannes W. J.
de Vries, Frank
Issue Date: 2015
Publisher: PUBLIC LIBRARY SCIENCE
Citation: PLOS ONE, 10 (12)
Abstract: Background Incidence rates of non-hip major osteoporotic fractures (MOF) remain poorly characterized in the Netherlands. The Dutch FRAX (R) algorithm, which predicts 10-year probabilities of hip fracture and MOF (first of hip, humerus, forearm, clinical vertebral), therefore incorporates imputed MOF rates. Swedish incidence rate ratios for hip fracture to MOF (Malmo 1987-1996) were used to perform this imputation. However, equality of these ratios between countries is uncertain and recent evidence is scarce. Aims were to estimate incidence rates of hip fracture and MOF and to compare observed MOF rates to those predicted by the imputation method for the Netherlands. Methods Using hospitalisation and general practitioner records from the Dutch PHARMO Database Network (2002-2011) we calculated age-and-sex-specific and age-standardized incidence rates (IRs) of hip and other MOFs (humerus, forearm, clinical vertebral) and as used in FRAX (R). Observed MOF rates were compared to those predicted among community-dwelling individuals >= 50 years by the standardized incidence ratio (SIR; 95% CI). Results Age-standardized IRs (per 10,000 person-years) of MOF among men and women >= 50 years were 25.9 and 77.0, respectively. These numbers were 9.3 and 24.0 for hip fracture. Among women 55-84 years, observed MOF rates were significantly higher than predicted (SIR ranged between 1.12-1.50, depending on age). In men, the imputation method performed reasonable. Conclusion Observed MOF incidence was higher than predicted for community-dwelling women over a wide age-range, while it agreed reasonable for men. As miscalibration may influence treatment decisions, there is a need for confirmation of results in another data source. Until then, the Dutch FRAX1output should be interpreted with caution.
Notes: [Klop, Corinne; Leufkens, Hubert G. M.; de Vries, Frank] Univ Utrecht, Utrecht Inst Pharmaceut Sci, Div Pharmacoepidemiol & Clin Pharmacol, Utrecht, Netherlands. [Welsing, Paco M. J.; Bijlsma, Johannes W. J.] Univ Med Ctr, Dept Rheumatol & Clin Immunol, Utrecht, Netherlands. [Welsing, Paco M. J.] Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [Elders, Petra J. M.] Vrije Univ Amsterdam, Med Ctr, Dept Gen Practice & Elderly Care, Amsterdam, Netherlands. [Overbeek, Jetty A.] PHARMO Inst Drug Outcomes Res, Utrecht, Netherlands. [van den Bergh, Joop P.] Viecuri Med Ctr, Dept Internal Med, Venlo, Netherlands. [van den Bergh, Joop P.] Maastricht Univ, Med Ctr, Dept Internal Med, NL-6200 MD Maastricht, Netherlands. [van den Bergh, Joop P.] Univ Hasselt, Biomed Res Inst, Hasselt, Belgium. [de Vries, Frank] Maastricht Univ, Med Ctr, Dept Clin Pharm & Toxicol, NL-6200 MD Maastricht, Netherlands. [de Vries, Frank] Southampton Gen Hosp, MRC Lifecourse Epidemiol Unit, Southampton SO9 4XY, Hants, England.
URI: http://hdl.handle.net/1942/20634
DOI: 10.1371/journal.pone.0143800
ISI #: 000366040000022
ISSN: 1932-6203
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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