Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate

SUMMARY: Fracture probabilities derived from the surrogate FRAX model for Armenia were compared to those from the model based on regional estimates of the incidence of hip fracture. Disparities between the surrogate and authentic FRAX models indicate the importance of developing country-specific FRA...

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Autores principales: Lesnyak, O., Sahakyan, S., Zakroyeva, A., Bilezikian, J. P., Hutchings, N., Babalyan, V., Galstyan, R., Lebedev, A., Johansson, H., Harvey, N. C., McCloskey, E., Kanis, John A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676826/
https://www.ncbi.nlm.nih.gov/pubmed/29116417
http://dx.doi.org/10.1007/s11657-017-0392-6
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author Lesnyak, O.
Sahakyan, S.
Zakroyeva, A.
Bilezikian, J. P.
Hutchings, N.
Babalyan, V.
Galstyan, R.
Lebedev, A.
Johansson, H.
Harvey, N. C.
McCloskey, E.
Kanis, John A.
author_facet Lesnyak, O.
Sahakyan, S.
Zakroyeva, A.
Bilezikian, J. P.
Hutchings, N.
Babalyan, V.
Galstyan, R.
Lebedev, A.
Johansson, H.
Harvey, N. C.
McCloskey, E.
Kanis, John A.
author_sort Lesnyak, O.
collection PubMed
description SUMMARY: Fracture probabilities derived from the surrogate FRAX model for Armenia were compared to those from the model based on regional estimates of the incidence of hip fracture. Disparities between the surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal. OBJECTIVE: Armenia has relied on a surrogate FRAX model based on the fracture epidemiology of Romania. This paper describes the epidemiology of fragility fractures in Armenia used to create an Armenia-specific FRAX model with an aim of comparing this new model with the surrogate model. METHODS: We carried out a population-based study in two regions of Armenia (Ararat and Vayots Dzor representing approximately 11% of the country’s population). We aimed to identify all low-energy fractures: retrospectively from hospital registers in 2011–2012 and prospectively in 2013 with the inclusion of primary care sources. RESULTS: The differences in incidence between the surveys with and without data from primary care suggested that 44% of patients sustaining a hip fracture did not receive specialized medical care. A similar proportion of forearm and humeral fractures did not come to hospital attention (48 and 49%, respectively). Only 57.7% of patients sustaining a hip fracture were hospitalized. In 2013, hip fracture incidence at the age of 50 years or more was 201/100,000 for women and 136/100,000 for men, and age- and sex-specific rates were incorporated into the new “authentic” FRAX model for Armenia. Compared to the surrogate model, the authentic model gave lower 10-year fracture probabilities in men and women aged less than 70 years but substantially higher above this age. Notwithstanding, there were very close correlations in fracture probabilities between the surrogate and authentic models (> 0.99) so that the revisions had little impact on the rank order of risk. CONCLUSION: A substantial proportion of major osteoporotic fractures in Armenia do not come to hospital attention. The disparities between surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal.
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spelling pubmed-56768262017-11-21 Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate Lesnyak, O. Sahakyan, S. Zakroyeva, A. Bilezikian, J. P. Hutchings, N. Babalyan, V. Galstyan, R. Lebedev, A. Johansson, H. Harvey, N. C. McCloskey, E. Kanis, John A. Arch Osteoporos Original Article SUMMARY: Fracture probabilities derived from the surrogate FRAX model for Armenia were compared to those from the model based on regional estimates of the incidence of hip fracture. Disparities between the surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal. OBJECTIVE: Armenia has relied on a surrogate FRAX model based on the fracture epidemiology of Romania. This paper describes the epidemiology of fragility fractures in Armenia used to create an Armenia-specific FRAX model with an aim of comparing this new model with the surrogate model. METHODS: We carried out a population-based study in two regions of Armenia (Ararat and Vayots Dzor representing approximately 11% of the country’s population). We aimed to identify all low-energy fractures: retrospectively from hospital registers in 2011–2012 and prospectively in 2013 with the inclusion of primary care sources. RESULTS: The differences in incidence between the surveys with and without data from primary care suggested that 44% of patients sustaining a hip fracture did not receive specialized medical care. A similar proportion of forearm and humeral fractures did not come to hospital attention (48 and 49%, respectively). Only 57.7% of patients sustaining a hip fracture were hospitalized. In 2013, hip fracture incidence at the age of 50 years or more was 201/100,000 for women and 136/100,000 for men, and age- and sex-specific rates were incorporated into the new “authentic” FRAX model for Armenia. Compared to the surrogate model, the authentic model gave lower 10-year fracture probabilities in men and women aged less than 70 years but substantially higher above this age. Notwithstanding, there were very close correlations in fracture probabilities between the surrogate and authentic models (> 0.99) so that the revisions had little impact on the rank order of risk. CONCLUSION: A substantial proportion of major osteoporotic fractures in Armenia do not come to hospital attention. The disparities between surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal. Springer London 2017-11-07 2017 /pmc/articles/PMC5676826/ /pubmed/29116417 http://dx.doi.org/10.1007/s11657-017-0392-6 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Lesnyak, O.
Sahakyan, S.
Zakroyeva, A.
Bilezikian, J. P.
Hutchings, N.
Babalyan, V.
Galstyan, R.
Lebedev, A.
Johansson, H.
Harvey, N. C.
McCloskey, E.
Kanis, John A.
Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate
title Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate
title_full Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate
title_fullStr Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate
title_full_unstemmed Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate
title_short Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate
title_sort epidemiology of fractures in armenia: development of a country-specific frax model and comparison to its surrogate
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676826/
https://www.ncbi.nlm.nih.gov/pubmed/29116417
http://dx.doi.org/10.1007/s11657-017-0392-6
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