Five-year fracture risk estimation in patients with Parkinson's disease

Bone. 2013 Jun 22. pii: S8756-3282(13)00236-6. doi: 10.1016/j.bone.2013.06.018. [Epub ahead of print]

Pouwels S, Bazelier MT, de Boer A, Weber WE, Neef CK, Cooper C, de Vries F.

Source

Utrecht Institute for Pharmaceutical Sciences, Universiteit Utrecht, Netherlands. Electronic address: s.pouwels@uu.nl.

Abstract

BACKGROUND:

Previous studies have shown that patients with Parkinson's Disease (PD) are at increased risk of fractures. However, no specific prediction model for fracture estimation among PD patients is currently available. Therefore, the aim of this study was to develop a simple score for estimating the 5-year osteoporotic and hip fracture risk among patients with PD.

METHODS:

The UK Clinical Practice Research Datalink (1987-2011) was used to identify incident PD patients. Cox proportional-hazards models were used to calculate the 5-year risk of osteoporotic and hip fracture among PD patients. The regression model was fitted with various risk factors for fracture and the final Cox model was converted into integer risk scores.

RESULTS:

We identified 4,411 incident PD patients without a history of osteoporotic treatment. The 5-year risks of osteoporotic and hip fracture were plotted in relation to the risk score. Risk scores increased with age, female gender, history of renal disease and history of dementia. The C-statistic, which is a parameter to test the internal validity of the model, was reasonable for the prediction of osteoporotic fracture (0.69) and hip fracture (0.73).

CONCLUSION:

In this study, we developed a simple model to estimate 5-year fracture risk among incident PD patients. It may be useful in daily practice after external validation.