Fracture risk assessment in Latin America: is Frax an adaptable instrument for the region?
Osteoporosis is a generalized disease of bone that increases fracture risk. Multiple factors influence this risk, besides low bone mass. To decrease osteoporotic fractures, those patients who require preventive management should be readily identified. This paper aims to review current information on the use of the fracture risk assessment tool (FRAX) in Latin America. Bone mineral density measurement is currently the method of reference for evaluating the fracture risk and opting for treatment; but, it misses a notable proportion of individuals who have clinical risk factors for osteoporosis and fractures. FRAX was designed to predict the 10-year absolute risk of sustaining a major osteoporotic fracture or a hip fracture. Although data is available for several countries, from Latin America, only Argentina appears in the current version of the tool. Its present use in other Latin American countries is possible with some adaptations based in similarities of epidemiological information of each country with some of the existing databases. The cutoff value beyond which treatment should be initiated needs to be determined, based not only on clinical criteria, but also on economic considerations.
Morales-Torres
Jorge
J
Clínica de Osteoporosis, Hospital Aranda de Parra, Hidalgo 329-704, León, 37000 GTO, México. jorgitomorales@prodigy.net.mx
Clark
Patricia
P
Delezé-Hinojosa
Margarita
M
Cons-Molina
Fidencio
F
Messina
Osvaldo Daniel
OD
Hernández
Jaime
J
Jaller-Raad
Juan José
JJ
Quevedo-Solidoro
Héctor
H
Radominski
Sebastiao Cezar
SC
D015519:Bone Density; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D012306:Risk; D018570:Risk Assessment