title: Clinical predictors of vertebral osteoporotic fractures in post-menopausal women:  a cross-sectional analysis.
abstract: BACKGROUND
  Osteoporosis is a very common bone disorder and accounts for 1.4 million vertebral compression fractures (VCFs) per year, mostly in post-menopausal women.
  
  
  OBJECTIVE
  The aim of this study was to develop a risk scoring system to identify and gauge the risk of osteoporotic VCFs in post-menopausal women.
  
  
  METHODS
  We conducted a retrospective cross-sectional study on 477 post-menopausal women consecutively visited at our institution. We studied 15 different clinical variables, i.e. age, body mass index (BMI), weight, L1-L4 lumbar T-Score, L1-L4 lumbar Z-Score, L1-L4 lumbar bone mineral density (BMD), femoral neck T-Score, femoral neck Z-Score, femoral neck BMD, smoking habit, alcohol consumption, 25-OH-vitamin D, total alkaline phosphatase, bone alkaline phosphatase, and L4 vertebral volume. Study population was split in a derivation and a validation cohort. A logistic regression model was used to develop a predictive score of osteoporotic VCFs in the derivation cohort, finally the performance of the score was tested in the validation cohort.
  
  
  RESULTS
  Age, L1-L4 lumbar T-Score, femoral neck T-Score, L4 vertebral volume, and smoking habit were found to be predictors of VCFs. To each variable a score from 0 to +12 was assigned to the magnitude of regression coefficient. A score ≥ 22 identified VCFs with a sensitivity of 87%/89% and a specificity of 87%/90% in the derivation and validation cohorts, respectively.
  
  
  CONCLUSIONS
  Our findings indicate that a simple score derived from clinical history and routine diagnostic workout can be usefully employed to gauge the risk of fragility VCFs in post-menopausal women.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy. luigiaurelionasto@yahoo.it
authors.forename: L A
authors.initials: LA
authors.lastname: Nasto
authors.forename: A
authors.initials: A
authors.lastname: Fusco
authors.forename: D
authors.initials: D
authors.lastname: Colangelo
authors.forename: M
authors.initials: M
authors.lastname: Mormando
authors.forename: G
authors.initials: G
authors.lastname: Di Giacomo
authors.forename: B
authors.initials: B
authors.lastname: Rossi
authors.forename: L
authors.initials: L
authors.lastname: De Marinis
authors.forename: C A
authors.initials: CA
authors.lastname: Logroscino
authors.forename: E
authors.initials: E
authors.lastname: Pola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000209:etiology*; D017698:Postmenopause; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology*