Pandyan, A, Ihama, F and Roffe, C (2020) Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study. European Geriatric Medicine. ISSN 1878-7649

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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.

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.

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).

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 - please refer to any applicable terms of use of the publisher. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Uncontrolled Keywords: Fragility fracture, Tools, Risk assessment, Care home residents
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
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: 15 Jul 2021 10:21

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