Evaluation of Risk Factors for Primary Fracture in Elderly Patients with Osteoporosis

Introduction: Osteoporosis is one of the major fundamental causes of fractures in individuals over 50 years old. Preventing the first fragility fracture is the most cost-effective strategy for addressing osteoporosis. Therefore, identifying individuals with a high risk of developing osteoporotic fractures is important to save limited medical resources. The Fracture Risk Assessment Tool (FRAX) has been used globally for assessing fracture risk. However, the accuracy of FRAX still needs to be improved partially because of the differences in race and socioeconomic status among nationalities. Methods: In this study, we evaluated the effectiveness of FRAX in Chinese people. The factors not involved in FRAX were also evaluated for a correlation with osteoporotic fracture risks. Results: Age, smoking status, alcohol intake, family history of osteoporotic fracture, diabetes mellitus type II, Charlson Index, vitamin D intake, calcium intake, muscle strength, modified Barthel Index, the 3-level version of EuroQol five dimensions questionnaire, and bone mineral density demonstrated significant differences between the fracture and control groups. Our results also demonstrated that dual-energy X-ray absorptiometry (DEXA)-diagnosed osteoporosis (T ≤ −2.5) was the independent fracture risk factor. The effects of age, muscle strength, and Charlson Index on DEXA were found to be statistically significant. People old over 60, muscle strength test supine leg lift less than 20 times per minute, aCCI scores greater than or equal to 2, had lower DEXA T values (T ≤ −2.5). Discussion: This work was a single-center study, showed social economic status bias, and featured a limited number of cases. Therefore, multi-center studies are necessary in the future. Conclusions: This study revealed that FRAX should be improved further in combination with other risk factors, including aCCI, calcium intake, and muscle strength.