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- Publisher Website: 10.1093/gerona/glz178
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Article: Development and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study
Title | Development and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study |
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Authors | |
Keywords | HKOS score osteoporosis BMD CVA falls |
Issue Date | 2020 |
Publisher | Oxford University Press. |
Citation | Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, 2020, v. 75 n. 5, p. 980-986 How to Cite? |
Abstract | BACKGROUND: To evaluate whether the common risk factors and risk scores (FRAX, QFracture and Garvan) can predict hip fracture in the oldest old (defined as age≥80), and to develop an oldest-old specific 10-year hip fracture prediction risk algorithm. METHODS: Subjects aged≥80 without history of hip fracture were studied. For the derivation cohort (N=251, mean age=83), participants were enrolled with a median follow-up time of 8.9 years. For the validation cohort (N=599, mean age=85), outpatients were enrolled with a median follow-up of 2.6 years. A 5-factor risk score (the HKOS score) for incident hip fracture was derived and validated, and its predictive accuracy was evaluated and compared with other risk scores. RESULTS: In the derivation cohort, the C-statistics were 0.65, 0.61, 0.65, 0.76 and 0.78 for FRAX with bone mineral density (BMD), FRAX without BMD, QFracture, Garvan, and the HKOS score, respectively. The category-less net reclassification index and integrated discrimination improvement of the HKOS score showed a better reclassification of hip fracture than FRAX and QFracture (all P<0.001) but not Garvan, while Garvan, but not HKOS score, showed a significant over-estimation in fracture risk (Hosmer-Lemeshow test p-value<0.001). In the validation cohort, the HKOS score had a C-statistic of 0.81 and a considerable agreement between expected and observed fracture risk in calibration. CONCLUSION: The HKOS score can predict 10-year incident hip fracture among the oldest old in Hong Kong. The score may be useful in identifying the oldest old patients at risk of hip fracture in both community-dwelling and hospital settings. |
Persistent Identifier | http://hdl.handle.net/10722/275101 |
ISSN | 2023 Impact Factor: 4.3 2023 SCImago Journal Rankings: 1.285 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lam, MT | - |
dc.contributor.author | Sing, CW | - |
dc.contributor.author | Li, GHY | - |
dc.contributor.author | Kung, AWC | - |
dc.contributor.author | Tan, KCB | - |
dc.contributor.author | Cheung, CL | - |
dc.date.accessioned | 2019-09-10T02:35:29Z | - |
dc.date.available | 2019-09-10T02:35:29Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, 2020, v. 75 n. 5, p. 980-986 | - |
dc.identifier.issn | 1079-5006 | - |
dc.identifier.uri | http://hdl.handle.net/10722/275101 | - |
dc.description.abstract | BACKGROUND: To evaluate whether the common risk factors and risk scores (FRAX, QFracture and Garvan) can predict hip fracture in the oldest old (defined as age≥80), and to develop an oldest-old specific 10-year hip fracture prediction risk algorithm. METHODS: Subjects aged≥80 without history of hip fracture were studied. For the derivation cohort (N=251, mean age=83), participants were enrolled with a median follow-up time of 8.9 years. For the validation cohort (N=599, mean age=85), outpatients were enrolled with a median follow-up of 2.6 years. A 5-factor risk score (the HKOS score) for incident hip fracture was derived and validated, and its predictive accuracy was evaluated and compared with other risk scores. RESULTS: In the derivation cohort, the C-statistics were 0.65, 0.61, 0.65, 0.76 and 0.78 for FRAX with bone mineral density (BMD), FRAX without BMD, QFracture, Garvan, and the HKOS score, respectively. The category-less net reclassification index and integrated discrimination improvement of the HKOS score showed a better reclassification of hip fracture than FRAX and QFracture (all P<0.001) but not Garvan, while Garvan, but not HKOS score, showed a significant over-estimation in fracture risk (Hosmer-Lemeshow test p-value<0.001). In the validation cohort, the HKOS score had a C-statistic of 0.81 and a considerable agreement between expected and observed fracture risk in calibration. CONCLUSION: The HKOS score can predict 10-year incident hip fracture among the oldest old in Hong Kong. The score may be useful in identifying the oldest old patients at risk of hip fracture in both community-dwelling and hospital settings. | - |
dc.language | eng | - |
dc.publisher | Oxford University Press. | - |
dc.relation.ispartof | Journals of Gerontology. Series A: Biological Sciences & Medical Sciences | - |
dc.rights | This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journals of Gerontology. Series A: Biological Sciences & Medical Sciences following peer review. The definitive publisher-authenticated version Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, 2020, v. 75 n. 5, p. 980-986 is available online at: https://doi.org/10.1093/gerona/glz178 | - |
dc.subject | HKOS score | - |
dc.subject | osteoporosis | - |
dc.subject | BMD | - |
dc.subject | CVA | - |
dc.subject | falls | - |
dc.title | Development and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study | - |
dc.type | Article | - |
dc.identifier.email | Sing, CW: wingsing@hku.hk | - |
dc.identifier.email | Li, GHY: gloriali@hku.hk | - |
dc.identifier.email | Kung, AWC: awckung@hku.hk | - |
dc.identifier.email | Tan, KCB: kcbtan@hkucc.hku.hk | - |
dc.identifier.email | Cheung, CL: lung1212@hku.hk | - |
dc.identifier.authority | Kung, AWC=rp00368 | - |
dc.identifier.authority | Tan, KCB=rp00402 | - |
dc.identifier.authority | Cheung, CL=rp01749 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1093/gerona/glz178 | - |
dc.identifier.pmid | 31353417 | - |
dc.identifier.scopus | eid_2-s2.0-85083911437 | - |
dc.identifier.hkuros | 304062 | - |
dc.identifier.volume | 75 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 980 | - |
dc.identifier.epage | 986 | - |
dc.identifier.isi | WOS:000537440900024 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1079-5006 | - |