[Impact of hormonal prevention on fractures of the proximal femur in postmenopausal women: a simulation study].
A simulation model of the effects of hormone replacement therapy (HRT) on hip fractures and their consequences is based on a population of 100,000 post-menopausal women. This cohort is confronted with literature derived probabilities of cancers (endometrium or breast, which are contra-indications to HRT), hip fracture, disability requiring nursing home or home care, and death. Administration of HRT for life prevents 55.5% of hip fractures, 22.6% of years with home care and 4.4% of years in nursing homes. If HRT is administered for 15 years, these results are 15.5%, 10% and 2.2%, respectively. A slight gain in life expectancy is observed for both durations of HRT. The net financial loss in the simulated population is 222 million Swiss Francs (cost/benefit ratio 1.25) for lifelong administration of HRT, and 153 million Swiss Francs (cost/benefit ratio 1.42) if HRT is administered during 15 years.
Van der Loos
M
M
Institut universitaire de médecine sociale et préventive, Lausanne.
Paccaud
F
F
Gutzwiller
F
F
Chrzanowski
R
R
D000368:Aged; D000369:Aged, 80 and over; D045166:Estradiol Congeners / Q000008:administration & dosage*; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D008593:Menopause / Q000187:drug effects; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control*; D012307:Risk Factors; D013557:Switzerland
D045166:Estradiol Congeners
Impact de la prophylaxie hormonale sur les fractures du fémur proximal des femmes postménopausiques: une étude de simulation.