Fall history can help clinicians determine future risk of fractures

Published on November 27, 2012 at 5:01 AM · No Comments

Clinicians are being urged to ask about a patient's history of falls as new research shows that the information is valuable in determining their future risk of fracture.

The likelihood of an individual sustaining a fracture is determined by the strength of their bones and the forces applied to them. Bone strength is dependent on bone density: the lower the bone density the higher risk of fracture. However, a bone usually only breaks when it is subjected to trauma, which in the majority of cases results from a fall.

Fracture risk assessment tools, such as the FRAX- model, have been developed to allow clinicians to accurately assess the risk of fracture for a patient. The calculation can include information on known risk factors such as age, sex, smoking, alcohol, family history, and certain diseases, with or without bone density. However, not all risk assessment tools include data on whether the individual has previously fallen.

New data from the Hertfordshire Cohort, which is published in the journal Bone, have shown that when knowledge of fall history is used the clinician's ability to predict whether an individual will break a bone is further improved.

Dr Mark Edwards, Clinical Research Fellow at the MRC Lifecourse Epidemiology Unit, University of Southampton, who led the study, comments: "In a clinical setting, asking whether a patient has fallen is quick and easy. Nearly 60 per cent of all hospital admissions due to fractures in England are the result of a fall. Fracture prediction is extremely important to allow us to target treatments to those at greatest risk: assessing falls history provides us a further tool with which to do so."

During the study the participants' risk factors, including age, sex, height, weight, family history, smoking, alcohol, rheumatoid arthritis, and whether they had a previous fracture or fall, were assessed along with bone density. At follow up each individual was asked whether they had suffered a new fracture.

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