Qfracture score

Q FractureScore

This is a new prediction algorithm which estimates the 10 year absolute risk of osteoporotic fractures and hip fractures in men and women (1)

• specifically developed by doctors and academics for use in the UK (2)
• it extends the age range and also takes into account additional variables than compared to FRAX, such as falls, type 2 diabetes, cardiovascular disease, use of HRT, menopausal symptoms, and use of tricyclic antidepressants
• does not require any laboratory testing or clinical measurements hence can be used in primary care

The factors used in QFracture score in men and women include

• age
• body mass index
• smoking status (non smoker, ex smoker, light, moderate, heavy)
• alcohol use
• rheumatoid arthritis
• cardiovascular disease
• type 2 diabetes
• asthma
• use of tricyclic antidepressants (at least 2 scripts in last 6 months)
• use of corticosteroids (at least 2 scripts in last 6 months)
• history of falls
• chronic liver disease

Additional factors are used in women:

• use of Hormone Replacement Therapy
• parental history of hip fracture/osteoporosis
• menopausal symptoms (vaginal dryness, hot sweats)
• gastrointestinal absorption (including Crohns disease, ulcerative colitis, celiac disease, steatorrhoea, blind loop syndrome)
• other endocrine disorders (thyrotoxicosis, primary or secondary hyperparathyroidism, Cushings syndrome) (2)

The web based risk calculator is available at the QFracture website.

Reference:

• 1. Hippisley-Cox J, Coupland C. Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ. 2009;339:b4229
• 2. QFracture. Risk calculator for hip fracture or osteoporotic fracture