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Eur J Epidemiol. 2006;21(11):815-22. Epub 2006 Nov 22.

Validation of the Cummings' risk score; how well does it identify women with high risk of hip fracture: the Tromsø Study.

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1
Institute of Community Medicine, University of Tromsø, 9037, Tromsø, Norway. Luai.Awad@ism.uit.no

Abstract

OBJECTIVE:

We examined a two-step case-finding strategy where the Cummings' risk score (NEJM 1995) was applied in a population-based setting together with bone mineral density (BMD) measurements in order to validate its ability to identify women with high risk of hip fracture.

METHODS:

All Tromsø women aged between 65 and 74 were invited to the Tromsø Osteoporosis Study (TROST) together with a 5% random sample of women aged 75-84 years (n = 1410). All had forearm BMD measurements in 1994/95 and were followed for 5 years with respect to first hip fracture. A risk score was constructed matching the Cummings score as closely as possible.

RESULTS:

In all 759, 578 and 73 women had 0-2, 3-4 and 5+ risk factors, respectively. Women with 5+ risk factors had a 5-year hip fracture risk of 11% (95% confidence interval (CI) 3.7-18.2%). BMD screening applied to these women identified 74% of them as osteoporotic and 19% as osteopenic with, respectively, 5-year hip fracture risk of 13% and 7.1%.

CONCLUSION:

In a population different from the one the score was generated in, this simple risk score identifies a group of women with high risk of hip fractures. With no additional BMD measurements, those high-risk women could benefit from early intervention measures.

PMID:
17119878
DOI:
10.1007/s10654-006-9072-3
[Indexed for MEDLINE]
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