Pandyan, A ORCID: https://orcid.org/0000-0002-2180-197X, Ihama, F and Roffe, C ORCID: https://orcid.org/0000-0002-5259-6649 (2020) Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study. European Geriatric Medicine.

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Abstract

Background
Fragility fractures are common in care home residents but established tools have not been tested in this population. Aim: To identify the most practicable tool for use.

Methods
Design
Multicentre prospective observational cohort pilot study. Setting: 18 care homes in Boston, UK. Assessments: fragility risk score at baseline with FRAX, QFractureScore, Garvan nomogram, body mass index and TUGT for each participant. Outcomes: falls, fractures, combined falls & fractures. Follow-up; 12 months.

Results
217/618 (35%) residents in the 18 care homes were enrolled. 147 (68%) had mental capacity,70 (32%) did not. There were 325 falls and 10 fractures in participants during the study. At the same time there were 1671 falls and 103 fractures in residents not participating in the study. Multiple regression analyses showed that only age had a statistically significant association with falls (χ2(1) = 5.7775, p = 0.0162), fractures (χ2(1) = 4.7269, p = 0.0297) and combined falls & fractures (χ2(1) = 4.7269, p = 0.0297). C-statistics were: falls; FRAX 0.544, BMI 0.610, QFractureScore 0.554, Garvan nomogram 0.579, TUGT 0.656, fractures; FRAX 0.655, BMI 0.708, QFractureScore 0.736, Garvan nomogram 0.712, TUGT 0.590, combined falls and fractures, c-statistics were same as for fractures. Fifty-four participants (25%) died during follow-up. Charlson comorbidity index predicted mortality, R2 = 0.021 (p = 0.034).

Conclusions
QFractureScore, BMI and Garvan nomogram were good predictors of fractures and combined falls and fractures Only age had statistically significant association with the outcomes. No tool was good predictor of falls.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Springer Nature at https://doi.org/10.1007/s41999-020-00383-2 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Fragility fracture, Tools, Risk assessment, Care home residents
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC952 Geriatrics
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 12 Oct 2020 17:46
Last Modified: 21 Nov 2020 12:50
URI: https://eprints.keele.ac.uk/id/eprint/8742

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