ArticleBMJ open2022
Comparison of fracture risk calculators in elderly fallers: a hospital-based cross-sectional study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Investigating traditional and novel predictors of a single versus multiple fragility fractures in a large observational cohort.PloS one · 2026Observational
- Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge.Bioengineering (Basel, Switzerland) · 2025Review
- The Fracture Phenotypes in Women and Men of 50 Years and Older with a Recent Clinical Fracture.Current osteoporosis reports · 2024Review
- Fracture risk prediction in postmenopausal women from GO Study: the comparison between FRAX, Garvan, and POL-RISK algorithms.Archives of osteoporosis · 2024Article
- Optimal fracture prediction thresholds for therapy onset, established from FRAX and Garvan algorithms: a longitudinal observation of the population representative female cohort from the RAC-OST-POL Study.Archives of osteoporosis · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveElderly patients presenting with falls are known to carry an extremely high risk of future fragility fractures. Current osteoporosis guidelines recommend using fracture risk calculators such as FRAX, QFracture or Garvan to guide management. However, they differ considerably in their inputs and may therefore provide contrasting risk estimations in certain individuals. In this study, we compare these risk calculators in a high-risk cohort of elderly patients admitted to hospital with falls.
designHospital-based cross-sectional study.
settingSecondary care, London, UK.
participantsData from 120 consecutive elderly patients who had falls presenting to a single hospital over 4 months were collected. 10-year major and hip fracture risks were calculated using FRAX, QFracture and Garvan. 1-year major and hip fracture risks from QFracture were assessed against prospective incidence of fracture.
resultsMedian 10-year major fracture risk was: FRAX 19.5%, QFracture 26.0%, Garvan 32.5%. Median 10-year hip fracture risk was: FRAX 9.6%, QFracture 21.1%, Garvan 6.5%. Correlation between FRAX and QFracture was r=0.672 for major, r=0.676 for hip fracture (both p<0.0001); FRAX and Garvan r=0.778 (p<0.0001) for major, r=0.128 (p=0.206) for hip fracture; QFracture and Garvan r=0.658 (p<0.0001) for major, r=0.318 (p<0.001) for hip fracture. QFracture 1-year predicted major and hip fracture rates were 1.8% and 1.2%, respectively, compared with actual rates of 2.1% and 0%, respectively.
conclusionsAlthough strong correlations between calculators were observed in the study cohort, there were differences of up to 13% between estimated risks. QFracture captured several elderly-specific inputs not considered by other calculators and so projected higher fracture risk than the other calculators. QFracture provided 1-year fracture risks that were comparable with the prospective observed fracture incidence in the cohort. This study has important clinical implications for the use of fracture risk calculators to guide treatment decisions, particularly in the high-risk cohort of elderly patients admitted to hospital following falls.
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