The Assessment of FRAX-based Osteoporotic Fracture Risk Probability among Nurses Aged 40-Years and Above in a Tertiary Care Hospital in Sri Lanka.

Abstract

Data related to the probability of osteoporotic fracture risk among nurses are not available in Sri Lanka. FRAX (Fracture Risk Assessment Tool) has the option to assess fracture risk without bone mineral density (BMD) values when Dual energy x-ray absorptiometry is not available. This study aimed to analyze the FRAX-based 10-year major osteoporotic fracture probability (MOFP) and the hip osteoporotic fracture probability (HOFP) among nurses aged 40-years and above in a tertiary care hospital in Sri Lanka. A standard questionnaire was administered to collect the data on socio-demographic characteristics and clinical risk factors for osteoporosis. A simple random sampling method was used to recruit 200 female nurses aged 40-years and above without a diagnosis of osteoporosis as the study population of this cross-sectional study. The FRAX-Sri Lanka tool was used to measure MOFP and HOFP without consideration of BMD. Chi-squared tests were utilized to assess the association between 10-year fracture risk probability and various categorical variables. Partial correlation analysis was used to analyze the association between fracture risk probability and body mass index (BMI) or duration of menopause. Of the 200 study subjects, Sinhalese constituted the majority (98.5%, n=197) with a mean age of 48.5±5.5 years. Menopause was significantly correlated with FRAX-based 10-year MOFP and HOFP estimated without consideration of BMD (p<0.001). The FRAX-based 10-year MOFP and HOFP estimated without consideration of BMD were 1.82% and 0.27%, respectively. A significant positive association was observed between menopausal duration and FRAX-based fracture probability after adjustment for age and BMI, while a significant negative association between BMI and FRAX-based fracture probability after adjustment for age was also identified. Further, a statistically significant association was observed between menopausal duration and FRAX-based 10-year MOFP (p=0.03) and between BMI and FRAX-based 10-year HOFP (p=0.001), without consideration of BMD. In conclusion, MOFP and HOFP estimated without consideration of BMD among Sri Lankan nurses aged 40-years and above were very low and below the FRAX-based treatment thresholds. Further studies involving several healthcare institutions and BMD values are encouraged to confirm our results.