Contribution of Clinical Risk Factors to the Assessment of Hip Fracture Risk and Treatment Decision Making
Osteoporosis is a seriously debilitating disease, particularly among postmenopausal white women in Western countries. Among women over 50 years in the United States, about one in six can anticipate a hip, vertebral, or forearm fracture sometime in their life. Among men, the risk is about 1 in 20 (Cummings and Melton, 2002). About 54% of women in this age group are osteopenic, and 30% are osteoporotic. By the age of 80 years, almost 70% of women become osteoporotic (Melton, 1995). In addition, the mortality risk approximately doubles in the „rst year after an osteoporotic fracture after the age of 60 years (Center et al., 1999). By 2025, annual costs of osteoporotic fractures are projected to increase by 50% to about $25 billion (Burge et al., 2007). These statistics are similar in Canada where osteoporosis affects one in four women and more than one in eight men over the age of 50 years (Goeree et al., 1996).