A FRAX model for the estimation of osteoporotic fracture probability in Portugal.

Andréa Marques, António Mota, Helena Canhão, José Carlos Romeu, Pedro Machado, Afonso Ruano, Ana Paula Barbosa, António Aroso Dias, Daniel Silva, Domingos Araújo, Eugénia Simões, Fernanda Aguas, Inês Rosendo, Inês Silva, Jorge Crespo, José Delgado Alves, Lúcia Costa, Mário Mascarenhas, Óscar Lourenço, Pedro Lopes FerreiraRaquel Lucas, Raquel Roque, Jaime Branco, Viviana Tavares, Helena Johansson, Jonh Kanis, José António Pereira da Silva

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The objective of this study was to develop a Portuguese version of the World Health Organization fracture risk assessment tool (FRAX®). All cases of hip fracture occurred at or after 40 years of age were extracted from the Portuguese National Hospital Discharge Register from 2006 to 2010. Age and sex-ranked population estimates and mortality rates were obtained from National Statistics. Age- and gender stratified incidences were computed and the average of the five years under consideration was taken. Rates for other major fractures were imputed from the epidemiology of Sweden, as undertaken for most national FRAX® models. All methodological aspects and results were submitted to critical appraisal by a wide panel of national experts and representatives of the different stakeholders, including patients. Hip fracture incidence rates were higher in women than in men and increased with age. The lowest incidence was observed in 40-44 years group (14.1 and 4.0 per 100,000 inhabitants for men and women, respectively). The highest rate was observed among the 95-100 age-group (2,577.6 and 3,551.8/100,000 inhabitants, for men and women, respectively). The estimated ten-year probability for major osteoporotic fracture or hip fracture increased with decreasing T-score and with increasing age. Portugal has one of the lowest fracture incidences among European countries. The FRAX® tool has been successfully calibrated to the Portuguese population, and can now be used to estimate the ten-year risk of osteoporotic fractures in this country. All major stakeholders officially endorsed the Portuguese FRAX® model and co-authored this paper.

Original languageEnglish
Pages (from-to)104-112
Number of pages9
JournalActa reumatológica portuguesa
Issue number2
Publication statusPublished - Apr 2013


  • 10-year fracture probability
  • FRAX
  • Hip fracture
  • Osteoporotic fracture


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