Estimation of 10- year probability bone fracture using WH

Introduction: Osteoporosis is a disease in which the density and quality of bone are reduced, leading to weakness of the skeleton and increased risk of fracture, particularly of the spine, hip, wrist, pelvis and upper arm[1]. The FRAX® tool has been developed by the World Health Organization to evaluate fracture risk of patients. It calculates 10-year probability of hip or major osteoporotic fracture. Objectives: As the proportion of aging population rises dramatically in Palestine, osteoporotic fractures have become a crucial health issue that must be addressed urgently. We assessed the prevalence of osteoporosis and estimated the 10-year probability of major osteoporotic fracture (MOF) and hip fracture (HF) among a selected sample above 50 years old. Methods: A convenient sample of 100 subjects was selected from Al-Rahmah clinic Nablus district during the study period between March 2012 and May 2012. A specially designed questionnaire was filled by the investigator including independent risk factors of osteoporosis selected by FRAX tool, in addition to others mentioned in literature. Dual energy X-ray absorpitometry was performed to measure bone mineral density (BMD), hip, and vertebral T score. Data extracted was then inserted to FRAX Palestine online WHO tool to calculate 10-year probability of major osteoporotic fracture and hip fracture in the selected sample. Results: In the total 100 subjects the median hip BMD was 0.82 (0.76-0.92) g\cm2. Mean vertebral T score was -1.41± 0.13 SDs, and mean hip T score was -0.91± 0.10 SDs. About one fifth of the sample (21%) had vertebral osteoporosis, while only five percent had hip osteoporosis. The median 10-year probability of MOF and HF based on BMD were 3.7 (2.43 – 6.18) %, and 0.30 (0.10 - 0.68) % respectively. Conclusion: In conclusion osteoporosis is common among Palestinian population above 50 years old (23% measured in our study), making fracture prevention strategies and research a priority in Palestine. Ongoing studies of fracture rates in Palestine should be followed up. Further studies on the accuracy and feasibility of the FRAX algorithm are essential for its clinical applicability.