Abstract
Introduction Established scores estimate 10-year fracture risk in
osteoporosis to assist with treatment recommendations. This study compared the
risk probabilities of major osteoporotic and hip fractures calculated by the
FRAX tool with those of the DVO score, established in German-speaking
countries.
Material and Methods This seven-year retrospective study analyzed data of
125 male patients (mean age: 59.2±10.7 years) evaluated for
osteoporosis. For the DVO score, the therapy threshold of>30%
for vertebral and hip fractures suggested by DVO guidelines was implemented. We
calculated fracture risks based on FRAX scores with aBMD and applied a common
therapy threshold of≥3% for hip fracture and subsequently
determined the “DVO-equivalent risk level” for FRAX-based
assessment that would identify as many male patients as identified by the DVO
score.
Results Based on DVO score, 60.0% of patients had a 10-year risk
of hip and vertebral fractures>30%. The recommendations for
individuals based on FRAX scores for hip fracture with aBMD with
risk≥3% overlapped with those based on DVO score in 36%
of patients. Patients identified for treatment only by DVO score presented a
higher percentage of spine fractures (65 vs. 41%). The thresholds for
this “DVO-equivalent risk level” for ‘FRAX with
aBMD’ was estimated to be≥6.7% for major osteoporotic
fracture and≥2.1% for hip fracture.
This study demonstrates that the DVO score was more sensitive than the FRAX score
for patients with prevalent spinal fractures. We suggest considering the
appropriate score and therapy threshold carefully in the daily care of male
patients.
Key words
bone mineral density - therapy threshold - osteoporosis risk factors - secondary osteoporosis
- 10-year fracture risk
