Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation.

Abstract

To assess the cost-effectiveness of interventions to prevent osteoporosis, it is necessary to estimate total health care expenditures for the treatment of osteoporotic fractures. Resources utilized for the treatment of many diseases can be estimated from secondary databases using relevant diagnosis codes, but such codes do not indicate which fractures are osteoporotic in nature. Therefore, a panel of experts was convened to make judgments about the probabilities that fractures of different types might be related to osteoporosis according to patient age, gender, and race. A three-round Delphi process was applied to estimate the proportion of fractures related to osteoporosis (i.e., the osteoporosis attribution probabilities) in 72 categories comprised of four specific fracture types (hip, spine, forearm, all other sites combined) stratified by three age groups (45-64 years, 65-84 years, 85 years and older), three racial groups (white, black, all others), and both genders (female, male). It was estimated that at least 90% of all hip and spine fractures among elderly white women should be attributed to osteoporosis. Much smaller proportions of the other fractures were attributed to osteoporosis. Regardless of fracture type, attribution probabilities were less for men than women and generally less for non-whites than whites. These probabilities will be used to estimate the total direct medical costs associated with osteoporosis-related fractures in the United States.

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@article{Melton1997FracturesAT, title={Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation.}, author={Lee Joseph Melton and Mae Thamer and Nancy Fox Ray and Jo Kay Chan and Charles H. Chesnut and Thomas A. Einhorn and C. Conrad Johnston and Lawrence G. Raisz and Stuart L. Silverman and Ethel S. Siris}, journal={Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research}, year={1997}, volume={12 1}, pages={16-23} }