Abstract
To extend elderly patients’ active longevity, practitioners all over the world need a precise clinical instrument to assess the 10-year osteoporotic fractures probability and choose the optimal preventive intervention. The purpose of this research is to assess major osteoporotic (OP) fractures incidence in CIS countries and to create country-specific computing FRAX clinical prediction tools. Method. We carried out a cohort population-based study (EVA) in Russia, Belarus, Armenia, Moldova, Kazakhstan, and Uzbekistan in 2011-2018. The age- and sexspecific OP fracture incidence values were incorporated into the computing FRAX models. Results. We revealed that the highest standardized HP incidence was obtained in Kazakhstan (338 and 255 per 100 000 per year for women and men older than 50 years resp.) and Moldova (331, 0 and 155, 0 per year for women and men resp.), the lowest in Armenia (201 and 136 per 100 000 per year for women and men resp.). The FRAX models showed that in Kazakhstan, Uzbekistan, and Moldova, elderly people had the highest hip fracture probabilities. Estimates reveal that the OP fractures numbers in the EVA-project countries will grow by 1.5-3 times by 2050. Conclusion. The created national FRAX instruments should enhance the accuracy of determining fracture probability among older people, help clinicians to make decisions concerning OP prophylactic, and to step forward to reducing the burden of age-related diseases.
Highlights
With the population aging, the prevalence of chronic age-related diseases such as osteoporosis and fragility fractures caused thereby is increasing considerably
High rates of nonadmittance patients have been reported in Pervouralsk, Russia (27%), Armenia (44%), and Belarus (29% of cases) and Kazakhstan (29%) [8,9,10,11]
The number of people that did not underwent specialized traumatological care increased dramatically with age, especially in Uzbekistan. These hidden hip fracture cases that escaped from official medical statistics reinforce a view that data on hip fracture based solely on hospital records are unreliable in this region of the world
Summary
The prevalence of chronic age-related diseases such as osteoporosis and fragility fractures caused thereby is increasing considerably. A wide variety of treatments are available that favourably affect bone mass and decrease the risk of fractures associated with osteoporosis [3]. The use of such interventions by health care practitioners is assisted by instruments that assess patients’ fracture risk to optimize clinical decisions concerning prevention and treatment. The most widely used web-based tool FRAX® (https://www.sheffield.ac.uk/FRAX/) meets these requirements and computes the 10-year probability of fragility fractures based on several common clinical risk factors and, optionally, on a DXA scan result [4, 5]. FRAX instruments will allow practitioners to assess 10-year osteoporotic fractures probability in elderly patients and choose the optimal intervention, decreasing fragile fracture risk as well as extending patients’ active longevity
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