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Updated fracture incidence rates for the Italian version of FRAX®

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Abstract

Summary

In order to update data underlying the Italian version of FRAX, we computed the national hip fracture incidence in Italy from hospitalization records for the year 2008. Mortality data and 10-year probabilities of major osteoporotic fractures were also updated. This revision will improve FRAX accuracy and reliability.

Introduction

The original Italian version of FRAX® was based on five regional estimates of hip fracture risk undertaken up to 20 years previously. Our objective was to update hip fracture rates for the model with more recently derived data from the whole Italian population and more recent data on mortality.

Methods

We analyzed the Italian national hospitalization database for the year 2008 in order to compute age- and sex-specific hip fracture incidence rates. Re-hospitalisations of the same patients within 1 year were excluded from the analysis. Hip fracture incidence rates were computed for the age range of 40–100 years, whereas the original FRAX model lacked data on the youngest and oldest age groups. In addition, we used the national mortality data for the same year 2008 to update the model. Ten-year fracture probabilities were re-calculated on the basis of the new fracture incidence rates.

Results

The new hip fracture age- and sex-specific incidence rates were close to those used in the original FRAX tool, although some significant differences (not exceeding 25–30 %) were found for men aged 65–75 years and women under 55 years of age. In general, the revision resulted in decreased estimated 10-year probabilities in the younger age groups, whilst those in the older age groups were slightly increased.

Conclusions

The Italian version of FRAX has been updated using the new fracture incidence rates. The impact of these revisions on FRAX is likely to increase the accuracy and reliability of FRAX in estimating 10-year fracture probabilities.

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Acknowledgments

This study has been designed at Florence University, Department of Internal Medicine and it has been supported by ONDA national observatory on women’s health through a special fellowship provided by Amgen Dompè. We are grateful to the FRAX group for the assistance in implementing this study. We thank the President of the Italian Senate Inquiry Commission on the Efficacy and Efficiency of Healthcare System, Senator I.R. Marino, Dr. L. Lispi (General Direction for Planning Affairs, Italian Ministry of Health) and Prof. A. Giordano (SHRO) for their contribution in the collection of national hospitalizations data upon which this revision is based. We also thank the OSTEOLAB research group at the Euro Mediterranean Scientific Biomedical Institute, ISBEM (Brindisi) and ORTOMED (Italian Society of Orthopaedics and Medicine).

Conflicts of interest

PP has received grants for consulting/speaking by Amgen Dompè, Ely Lilly and Servier; MLB has received research grant and funding for consulting/speaking by Novartis, Stroder, Servier, Ely Lilly, Roche, Nicomed and Amgen Dompè; JAK has declared no competing interests with respect to this paper; DMB has received research funding from Novartis, Merck and Roche/Genentech and consulting fees from Nycomed, Amgen and Zosano; GC has received a fellowship from ONDA Italian National Women’s Health Observatory supported by a grant from Amgen Dompè for this project; HJ declares no disclosures.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Florence, Largo Palagi 1, 50138, Florence, Italy

    P. Piscitelli & M. L. Brandi

  2. Euro Mediterranean Scientific Biomedical Institute, ISBEM, Brindisi, Italy

    G. Chitano

  3. University of Sheffield, Sheffield, UK

    H. Johannson & J. A. Kanis

  4. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA

    D. M. Black

Authors
  1. P. Piscitelli
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  2. G. Chitano
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  3. H. Johannson
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  4. M. L. Brandi
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  5. J. A. Kanis
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  6. D. M. Black
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Correspondence to P. Piscitelli.

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Piscitelli, P., Chitano, G., Johannson, H. et al. Updated fracture incidence rates for the Italian version of FRAX®. Osteoporos Int 24, 859–866 (2013). https://doi.org/10.1007/s00198-012-2021-y

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  • DOI: https://doi.org/10.1007/s00198-012-2021-y

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