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Article: Development and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study

TitleDevelopment and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study
Authors
KeywordsHKOS score
osteoporosis
BMD
CVA
falls
Issue Date2019
PublisherOxford University Press. The Journal's web site is located at http://biomed.gerontologyjournals.org/
Citation
Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, 2019, Epub How to Cite?
AbstractBACKGROUND: To evaluate whether the common risk factors and risk scores (FRAX, QFracture and Garvan) can predict hip fracture in the oldest old (defined as age≥80), and to develop an oldest-old specific 10-year hip fracture prediction risk algorithm. METHODS: Subjects aged≥80 without history of hip fracture were studied. For the derivation cohort (N=251, mean age=83), participants were enrolled with a median follow-up time of 8.9 years. For the validation cohort (N=599, mean age=85), outpatients were enrolled with a median follow-up of 2.6 years. A 5-factor risk score (the HKOS score) for incident hip fracture was derived and validated, and its predictive accuracy was evaluated and compared with other risk scores. RESULTS: In the derivation cohort, the C-statistics were 0.65, 0.61, 0.65, 0.76 and 0.78 for FRAX with bone mineral density (BMD), FRAX without BMD, QFracture, Garvan, and the HKOS score, respectively. The category-less net reclassification index and integrated discrimination improvement of the HKOS score showed a better reclassification of hip fracture than FRAX and QFracture (all P<0.001) but not Garvan, while Garvan, but not HKOS score, showed a significant over-estimation in fracture risk (Hosmer-Lemeshow test p-value<0.001). In the validation cohort, the HKOS score had a C-statistic of 0.81 and a considerable agreement between expected and observed fracture risk in calibration. CONCLUSION: The HKOS score can predict 10-year incident hip fracture among the oldest old in Hong Kong. The score may be useful in identifying the oldest old patients at risk of hip fracture in both community-dwelling and hospital settings.
Persistent Identifierhttp://hdl.handle.net/10722/275101
ISSN
2017 Impact Factor: 4.902
2015 SCImago Journal Rankings: 2.675

 

DC FieldValueLanguage
dc.contributor.authorLam, MT-
dc.contributor.authorSing, CW-
dc.contributor.authorLi, GHY-
dc.contributor.authorKung, AWC-
dc.contributor.authorTan, KCB-
dc.contributor.authorCheung, CL-
dc.date.accessioned2019-09-10T02:35:29Z-
dc.date.available2019-09-10T02:35:29Z-
dc.date.issued2019-
dc.identifier.citationJournals of Gerontology. Series A: Biological Sciences & Medical Sciences, 2019, Epub-
dc.identifier.issn1079-5006-
dc.identifier.urihttp://hdl.handle.net/10722/275101-
dc.description.abstractBACKGROUND: To evaluate whether the common risk factors and risk scores (FRAX, QFracture and Garvan) can predict hip fracture in the oldest old (defined as age≥80), and to develop an oldest-old specific 10-year hip fracture prediction risk algorithm. METHODS: Subjects aged≥80 without history of hip fracture were studied. For the derivation cohort (N=251, mean age=83), participants were enrolled with a median follow-up time of 8.9 years. For the validation cohort (N=599, mean age=85), outpatients were enrolled with a median follow-up of 2.6 years. A 5-factor risk score (the HKOS score) for incident hip fracture was derived and validated, and its predictive accuracy was evaluated and compared with other risk scores. RESULTS: In the derivation cohort, the C-statistics were 0.65, 0.61, 0.65, 0.76 and 0.78 for FRAX with bone mineral density (BMD), FRAX without BMD, QFracture, Garvan, and the HKOS score, respectively. The category-less net reclassification index and integrated discrimination improvement of the HKOS score showed a better reclassification of hip fracture than FRAX and QFracture (all P<0.001) but not Garvan, while Garvan, but not HKOS score, showed a significant over-estimation in fracture risk (Hosmer-Lemeshow test p-value<0.001). In the validation cohort, the HKOS score had a C-statistic of 0.81 and a considerable agreement between expected and observed fracture risk in calibration. CONCLUSION: The HKOS score can predict 10-year incident hip fracture among the oldest old in Hong Kong. The score may be useful in identifying the oldest old patients at risk of hip fracture in both community-dwelling and hospital settings.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://biomed.gerontologyjournals.org/-
dc.relation.ispartofJournals of Gerontology. Series A: Biological Sciences & Medical Sciences-
dc.subjectHKOS score-
dc.subjectosteoporosis-
dc.subjectBMD-
dc.subjectCVA-
dc.subjectfalls-
dc.titleDevelopment and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study-
dc.typeArticle-
dc.identifier.emailSing, CW: wingsing@hku.hk-
dc.identifier.emailLi, GHY: gloriali@hku.hk-
dc.identifier.emailKung, AWC: awckung@hku.hk-
dc.identifier.emailTan, KCB: kcbtan@hkucc.hku.hk-
dc.identifier.emailCheung, CL: lung1212@hku.hk-
dc.identifier.authorityKung, AWC=rp00368-
dc.identifier.authorityTan, KCB=rp00402-
dc.identifier.authorityCheung, CL=rp01749-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/gerona/glz178-
dc.identifier.pmid31353417-
dc.identifier.hkuros304062-
dc.publisher.placeUnited States-

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