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Fracture Risk Assessment Calculator
Reference tool for calculating risk of major osteoporatic fracture.
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this article
Based on FRAX: www.shef.ac.uk/FRAX
No BMD Measurement Available
Step 1: Assess patient for presence of Clinical Risk Factors.
Clinical risk factors |
|
- Previous fragility fracture, particularly of the hip, wrist and spine including radiographic evidence of 20% loss
of height of a vertebral body
- Parental history of hip fracture
- Current glucocorticoid treatment (any dose, by mouth for 3 months or more)
- Current smoking
- Alcohol intake of 3 or more units daily
|
- Secondary causes of osteoporosis including:
- Rheumatoid arthritis
- Untreated hypogonadism in men and women
- Prolonged immobility
- Organ transplantation
- Type 1 diabetes
- Hyperthyroidism
- Gastrointestinal disease
- Chronic liver disease
- Chronic obstructive pulmonary disease
|
Step 2: Use the tables to calculate the 10 year probability (%) of major
osteoporotic fracture risk based on age, gender, BMI and number of clinical risk factors.
MEN with or without previous fracture
No of CRFs |
Age 50 |
0 |
2.9 |
2.8 |
2.8 |
2.4 |
2.1 |
1 |
4.5 |
4.3 |
4.3 |
3.7 |
3.3 |
2 |
7.1 |
6.7 |
6.5 |
5.7 |
4.9 |
3 |
11 |
10 |
9.7 |
8.5 |
7.4 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
No of CRFs |
Age 60 |
0 |
4.2 |
4.0 |
3.9 |
3.4 |
2.9 |
1 |
6.5 |
6.1 |
6.0 |
5.2 |
4.5 |
2 |
10 |
9.3 |
8.9 |
7.7 |
6.7 |
3 |
15 |
14 |
13 |
11 |
9.9 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
No of CRFs |
Age 70 |
0 |
6.0 |
5.8 |
5.7 |
4.8 |
4.1 |
1 |
9.0 |
8.5 |
8.2 |
6.9 |
5.9 |
2 |
13 |
12 |
12 |
9.9 |
8.4 |
3 |
20 |
18 |
17 |
14 |
12 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
No of CRFs |
Age 80 |
0 |
7.8 |
7.4 |
7.2 |
5.9 |
4.8 |
1 |
12 |
11 |
11 |
8.7 |
7.1 |
2 |
19 |
17 |
16 |
13 |
10 |
3 |
27 |
25 |
23 |
19 |
15 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
WOMEN with
no previous fracture*
No of CRFs |
Age 50 |
0 |
3.9 |
3.6 |
3.5 |
3.0 |
2.6 |
1 |
6.3 |
5.7 |
5.4 |
4.7 |
4.1 |
2 |
9.9 |
8.8 |
8.2 |
7.2 |
6.3 |
3 |
15 |
13 |
12 |
11 |
9.5 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
No of CRFs |
Age 60 |
0 |
7.4 |
6.5 |
6.0 |
5.2 |
4.6 |
1 |
12 |
10 |
9.3 |
8.1 |
7.0 |
2 |
18 |
15 |
14 |
12 |
11 |
3 |
27 |
23 |
20 |
18 |
16 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
No of CRFs |
Age 70 |
0 |
14 |
12 |
11 |
9.5 |
8.2 |
1 |
21 |
18 |
16 |
14 |
12 |
2 |
31 |
26 |
23 |
20 |
17 |
3 |
44 |
37 |
32 |
28 |
24 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
No of CRFs |
Age 80 |
0 |
22 |
19 |
17 |
15 |
12 |
1 |
32 |
28 |
25 |
21 |
18 |
2 |
44 |
40 |
35 |
30 |
25 |
3 |
56 |
52 |
47 |
41 |
35 |
|
15 |
20 |
25 |
30 |
35 |
|
BMI |
|
Step 3: Intervention thresholds
|
|
Reassure |
|
Consider BMD test |
|
Consider Treatment |
|
BMD Measurement Available
Step 1: Assess patient for presence of Clinical Risk Factors.
Clinical risk factors |
|
- Previous fragility fracture, particularly of the hip, wrist and spine including radiographic evidence of 20% loss
of height of a vertebral body
- Parental history of hip fracture
- Current glucocorticoid treatment (any dose, by mouth for 3 months or more)
- Current smoking
- Alcohol intake of 3 or more units daily
|
- Secondary causes of osteoporosis including:
- Rheumatoid arthritis
- Untreated hypogonadism in men and women
- Prolonged immobility
- Organ transplantation
- Type 1 diabetes
- Hyperthyroidism
- Gastrointestinal disease
- Chronic liver disease
- Chronic obstructive pulmonary disease
|
Step 2: Use the tables to calculate the 10 year probability (%) of major
osteoporotic fracture risk based on age, gender, BMD and number of clinical risk factors.
MEN with or without previous fracture
No of CRFs |
Age 50 |
1 |
30 |
14 |
7.5 |
5.1 |
4.0 |
2 |
43 |
20 |
11 |
7.5 |
5.9 |
3 |
57 |
29 |
16 |
11 |
8.4 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
No of CRFs |
Age 60 |
1 |
31 |
16 |
9.6 |
6.4 |
5.0 |
2 |
41 |
23 |
14 |
9.2 |
7.1 |
3 |
53 |
31 |
19 |
13 |
10 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
No of CRFs |
Age 70 |
1 |
28 |
17 |
11 |
7.2 |
5.6 |
2 |
37 |
24 |
15 |
9.9 |
7.5 |
3 |
48 |
32 |
20 |
13 |
10 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
No of CRFs |
Age 80 |
1 |
23 |
16 |
10 |
7.0 |
5.3 |
2 |
32 |
22 |
15 |
10 |
7.3 |
3 |
42 |
31 |
21 |
14 |
10 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
WOMEN with
no previous fracture*
No of CRFs |
Age 50 |
1 |
26 |
13 |
7.6 |
5.5 |
4.8 |
2 |
37 |
19 |
11 |
8.1 |
7.0 |
3 |
51 |
27 |
16 |
12 |
10 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
No of CRFs |
Age 60 |
1 |
32 |
18 |
11 |
8.0 |
6.8 |
2 |
44 |
25 |
16 |
12 |
9.8 |
3 |
58 |
35 |
23 |
16 |
14 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
No of CRFs |
Age 70 |
1 |
41 |
25 |
15 |
11 |
8.9 |
2 |
54 |
34 |
21 |
15 |
12 |
3 |
67 |
45 |
29 |
20 |
16 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
No of CRFs |
Age 80 |
1 |
45 |
29 |
19 |
13 |
9.6 |
2 |
57 |
40 |
26 |
18 |
13 |
3 |
67 |
51 |
35 |
25 |
17 |
|
-4 |
-3 |
-2 |
-1 |
0 |
|
BMD |
|
Step 3: Intervention thresholds
|
|
Reassure |
|
Consider Treatment |
|
Strongly Recommend Treatment |
|
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