Osteoporosis Screening Indicated Following Non-Vertebral Fractures Save

The Archives of Osteoporosis have published the results of a cohort study supporting the use of osteoporosis (OP) screening in those sustaining a non-vertebral fracture in patients over age 50 years, independent of sex of level of trauma sustained.

Analysis of 478 fracture patients (age of 69.3 yrs), 317 (66.3%) of whom were female and 161 (33.7%) male.

High-energy fractures (HEFs) were sustained by 119 patients (24.9%) and 359 (75.1%) had low-energy fractures (LEFs). All undewent densitometry (DXA).

Osteooporosis by DEXA was seen in 28% of males and 47% of females. Thus the number needed to screen (NNS) was 2.1 for women and 3.6 for men to identify OP.   The NNT was 1.5 for females and 2.4 for males if the fracture risk assessment tool (FRAX) was included in the diagnostics (DXA and FRAX).

The NNS for treatment following DXA and FRAX was 1.5 for LEF and 2.9 for HEF. Subgroup analysis revealed that HEF males within the decennia 50+ and 80+ had an NNS of around 3, i.e., comparable to females and about twice as high as LEF patients.

These results indicate the high yield in screening patients over age 50 years for OP when involved in non-vertebral fractures, regardless of gender or level of trauma energy.