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Revista Española de Salud Pública

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GOMEZ NAVARRO, Rafael. Use of the FRAX algorithm to calculate the fracture risk in women of a rural area. Rev. Esp. Salud Publica [online]. 2010, vol.84, n.3, pp.321-330. ISSN 1135-5727.

Background: Fractures induced by fragility are an important public health problem. To establish preventive interventions based on the absolute value of the fracture risk must turn into a priority. The objectives of this work are: to determine the absolute fracture risk in postmenopausal women and, depending on it, to consider the recommendations on the convenience of carrying out DEXA and/or of initiating a treatment a with antiresorptive agents. Methods: Descriptive cross-sectional study realized in a rural population. All the women between 40 and 90 years old were studied. Their fracture risk was calculated by means of the FRAX algorithm. To follow a treatment with antiresorptive agents and suffering a terminal illness were considered as a cause of exception. The recommendations regarding the request of DEXA and/or of initiating treatment were based on the European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Results: The final number of studied women promoted 76, with a middle ages of 67,9 ± 13,4. In them, the absolute risk of osteoporotic fracture 8,1 ± 7,9 and the risk of hip fracture 3,7 ± 5,3. To request DEXA is recommended in 9 (11,8 %) and to raise the beginning of treatment in 3 (3,9 %). In 9 (> 84 years), the Guide does not establish recommendations. The necessary number of women to screen to indicate the accomplishment of one DEXA is 8,4 and of 25,3 to initiate one treatment. We initiate it in the 3 recommended cases and in another one for which the Guide does not indicate any recommendation. Conclusion: FRAX alghorithm has facilitated to us the determination in a simple way of the absolute fracture risk and the hip fracture risk of the women of our population and has helped to us to decide to initiate treatment antirresortivo almost in 4 % of the studied ones.

Keywords : Osteoporosis; Postmenopause; Fracture; Primary health care; Spain.

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