279. DETERMINING FRACTURE RISK IN PATIENTS WITH A HISTORY OF RECURRENT FALLS: AN OBSERVATIONAL STUDY

Abstract

Background: Recurrent falls are a significant cause of morbidity and mortality in the general population. It is currently estimated that falls cost the NHS £2.3 billion every year. People aged 65 and over have the highest risk of falling. Approximately 5% of falls in the community among the older population result in a fracture or hospitalisation. Falls increase the risk of fractures and therefore prevention of fall prevention is paramount in preventing fractures. The FRAX tool is designed to predict fractures in vulnerable groups by using patient age and sex alongside other risk factors, including smoking and femoral neck bone mineral density. Our objective was to determine the predictors of fracture risk in a large observational cohort with a history of recurrent falls. Methods: Data were collected from 365 individuals who suffered recurrent falls between 2004 and 2016. The patients' age, gender, weight, medical history, lifestyle choices and dual-energy x-ray absorptiometry (DEXA) results were gathered. History of smoking, alcohol, family history of fracture, Rheumatoid Arthritis, bone mineral density (BMD) in both the lumbar spine and the femoral neck, height, weight, body mass index (BMI), gender, age at scan and steroid use were used as predictors. Univariate and multivariate logistic regression models were used to predict fractures in the cohort using the above explanatory variables. Results: 365 patients were included in the analysis. 198 (54%) had sustained a fracture, using the demographics shown in Table 1. The mean age at scan was 70.28 years (SD 11.50). Univariate analysis showed that bone mineral density of the lumbar spine is associated with fracture in this cohort. The multivariate analysis model also showed that the lumbar spine bone mineral density is a predictor for fracture in this recurrent falls cohort. Conclusion: The univariate analysis and multivariate analysis showed that bone mineral density of the lumbar spine is a predictor for fracture in this cohort. Femoral neck bone mineral density is not a predictor in this cohort. Therefore, the FRAX tool may underestimate the risk of fracture in this group.