ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2022
Improved fracture risk prediction by adding VFA-identified vertebral fracture data to BMD by DXA and clinical risk factors used in FRAX.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Association between a history of major osteoporotic fractures and subsequent hip fracture: a systematic review and meta-analysis.Archives of osteoporosis · 2024Pooled it
- Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Pooled it
- Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Guideline
- Vertebral fractures identified on lateral DXA images by deep learning predict incident fractures in older women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Vertebral Fracture as a Predictor of Subsequent Extremity Fractures: A Systematic Review.Journal of clinical medicine · 2026Review
- A machine learning tool for predicting newly diagnosed osteoporosis in primary healthcare in the Stockholm Region.Scientific reports · 2025Article
- Article
- Barriers and solutions for global access to osteoporosis management: a Position Paper from the International Osteoporosis Foundation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Review
- Prediction of hip fracture by high-resolution peripheral quantitative computed tomography in older Swedish women.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Trabecular texture and paraspinal muscle characteristics for prediction of first vertebral fracture: a QCT analysis from the AGES cohort.Frontiers in endocrinology · 2025Article
- The Fracture Phenotypes in Women and Men of 50 Years and Older with a Recent Clinical Fracture.Current osteoporosis reports · 2024Review
- Prediction of Subsequent Vertebral Fracture After Acute Osteoporotic Fractures from Clinical and Paraspinal Muscle Features.Calcified tissue international · 2024Article
- Sarcopenia definitions and their association with fracture risk in older Swedish women.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
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- Article
- Hemoglobin Levels Improve Fracture Risk Prediction in Addition to FRAX Clinical Risk Factors and Bone Mineral Density.The Journal of clinical endocrinology and metabolism · 2023Article
- Quality improvement initiative: implementing routine vertebral fracture assessments into an Australian Fracture Liaison Service.BMJ open quality · 2023Article
- Adjusting FRAX Estimates of Fracture Probability Based on a Positive Vertebral Fracture Assessment.JAMA network open · 2023Article
- Active identification of vertebral fracture in the FLS model of care.Archives of osteoporosis · 2023Observational
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 4 countries.
Funding
Abstract
Vertebral fracture (VF) is a strong predictor of subsequent fracture. In this study of older women, VF, identified by dual-energy X-ray absorptiometry (DXA) vertebral fracture assessment (VFA), were associated with an increased risk of incident fractures and had a substantial impact on fracture probability, supporting the utility of VFA in clinical practice. PURPOSE: Clinical and occult VF can be identified using VFA with dual-energy X-ray absorptiometry (DXA). The aim of this study was to investigate to what extent VFA-identified VF improve fracture risk prediction, independently of bone mineral density (BMD) and clinical risk factors used in FRAX.
methodsA total of 2852 women, 75-80 years old, from the prospective population-based study SUPERB cohort, were included in this study. At baseline, BMD was measured by DXA, VF diagnosed by VFA, and questionnaires used to collect data on risk factors for fractures. Incident fractures were captured by X-ray records or by diagnosis codes. An extension of Poisson regression was used to estimate the association between VFA-identified VF and the risk of fracture and the 5- and 10-year probability of major osteoporotic fracture (MOF) was calculated from the hazard functions for fracture and death.
resultsDuring a median follow-up of 5.15 years (IQR 4.3-5.9 years), the number of women who died or suffered a MOF, clinical VF, or hip fracture was 229, 422, 160, and 124, respectively. A VFA-identified VF was associated with an increased risk of incident MOF (hazard ratio [HR] = 1.78; 95% confidence interval [CI] 1.46-2.18), clinical VF (HR = 2.88; 95% [CI] 2.11-3.93), and hip fracture (HR = 1.67; 95% [CI] 1.15-2.42), adjusted for age, height, and weight. For women at age 75 years, a VFA-identified VF was associated with 1.2-1.4-fold greater 10-year MOF probability compared with not taking VFA into account, depending on BMD.
conclusionIdentifying an occult VF using VFA has a substantial impact on fracture probability, indicating that VFA is an efficient method to improve fracture prediction in older women.
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