Prediction rule identifies risk of osteoporotic fracture

A prediction rule based on a heel stiffness index and four clinical factors can identify which elderly women are at high risk of osteoporotic fracture, according to a report in the July issue of Radiology.

Idris Guessous, MD, from Lausanne University Hospital in Switzerland, and colleagues used heel-bone quantitative ultrasonographic data from 6,174 Swiss women (70 to 85 years old) to calculate the stiffness index at the heel and its predictive value for osteoporotic fractures.

The researchers assigned points to the five identified risk factors: older age, low heel quantitative ultrasonographic stiffness index, history of fracture, recent fall, and a failed chair test. A cutoff of 4.5 produced a sensitivity of 90% and identified 4,710 women at higher risk of fracture. More of these high-risk women had an osteoporotic fracture (6.1 vs. 1.8%), and 90% of women who had a hip fracture were in the high-risk group.

“A prediction rule obtained by using quantitative ultrasonographic stiffness index and four clinical risk factors helped discriminate, with high sensitivity, women at higher versus those at lower risk for osteoporotic fracture,” Guessous and colleagues conclude.

Guessous I, Cornuz J, Ruffieux C, et al. Osteoporotic fracture risk in elderly women: estimation with quantitative heel US and clinical risk factors.

Radiology

. 2008;248:179-184.