65 Comparison of Frax and Qfracture in Predicting Fragility Fractures in Patients Presenting with Falls

Abstract

Abstract Introduction Falls are a major risk factor for fragility fractures and patients should be appropriately assessed to reduce future fragility fracture risk. National guidelines provide recommendations on assessing fracture risk using calculators to guide therapy initiation. FRAX and QFracture are the two main calculators used, however they differ considerably in their inputs. The aim of this study was to compare the risk estimation and performance between these two frequently used calculators to help determine their appropriate utility. Methods Data from patients aged ≥70 years admitted with a fall to the Acute Medical Units at Charing Cross Hospital between 1st Dec 2018–31st March 2019 were retrospectively collected, covering all inputs required for the two risk calculators. The 10-year major osteoporotic and hip fracture risks were calculated using FRAX and QFracture and compared. The one-year major osteoporotic and hip fracture risks from QFracture were assessed against actual one-year fracture rates. Results Conclusions Risk calculators are effective tools to aid the decision of bone therapy initiation. Here we demonstrate that there is a strong correlation between the two commonly used calculators. However, in terms of absolute risk values there is a mean 8.9% difference with QFracture providing higher risks in this “fallers” group. As absolute treatment thresholds are frequently used to guide bone therapy initiation, opposing recommendations may result. Therefore, there is a need to further explore calculator performance and determine which would more accurately serve different patient groups.