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Use of Clinical Risk Factors in the Assessment of Fracture Risk and its Application in Screening for Osteoporosis at Muhimbili Orthopaedic Institute: A Hospital-Based Cross Sectional Descriptive Study

Lema, G. (2011) Use of Clinical Risk Factors in the Assessment of Fracture Risk and its Application in Screening for Osteoporosis at Muhimbili Orthopaedic Institute: A Hospital-Based Cross Sectional Descriptive Study. Masters thesis, Muhimbili University of Health and Allied Sciences.

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Abstract

Use of Clinical risk factors in the assessment of fracture risk and its application in screening for osteoporosis at Muhimbili Orthopaedic Institute (MOI). To determine the Clinical Risk Factors used in the assessment of fracture risk and their application in the screening for osteoporosis at Muhimbili Orthopaedic Institute (MOI). This was a cross – sectional hospital based study conducted at Muhimbili Orthopaedic Institute from March to December 2009. A total of 20,038 trauma patients were managed at Muhimbili Orthopaedic Institute during the study period. Among this 560 patients met criteria for this study and were enrolled. Males were 42.9% (240) and female were 57.1% (320) with mean age 53 (SD ± 11) years. Of 560 patients 5.5% (31) had no clinical risk factors for osteoporosis. Males above 60 years had more clinical risk factors for osteoporosis 32.9% than the younger ones 7.6% (p = 0.001). The same was observed in females [46.2% versus 2.1% (p = 0.001)]. More females 64.5% (60) had osteoporotic fractures than males 35.5% (33) (p = 0.116). Independent risk factors for fractures observed in this study were age more than 60 years, body mass index less than18.5%kg/m2, cigarette smoking, physical inactivity and excessive alcohol intake. Clinical risk factors strongly associated with osteoporotic fractures in female were underweight (low BMI), Age, heavy cigarette smoking, allergic to milk, amount, duration, and type of alcohol consumed. While in males underweight (low BMI), Age, and sedentary life style (sleeping during the day) were significant associated with osteoporotic fracture. Prevalence of osteoporosis as analyzed by FRAX index tool was 21.3%. Out of 560, 6.8% (38) patients with 10 years probability of major osteoporotic fractures and 14.5% (81) patients with 10 years probability of hip fractures were identified. Females have high probability of osteoporosis hip fractures than males, 16.9% and 11.3% respectively. The proportion of adult who are attending or admitted to MOI with (WHO) risk factors for osteoporosis is high. There was a positive correlation of WHO Risk factors for osteoporosis with occurrence of osteoporosis and osteoporotic fractures. Clinical Risk Factors of osteoporosis through the FRAX tool, which have been used for fracture prognostication and screening for osteoporosis in absence of BMD is suitable in Muhimbili Orthopaedic Institute. Application of this tool enables us to identify individual at high risk of disabling fractures, thereby allowing careful allocation of expensive treatments to individuals most in need without using BMD determination test.

Item Type: Thesis (Masters)
Keywords: Osteoporosis, Clinical Risk, Muhimbili, Orthopaedic, Trauma patients,Tanzania
Subjects: Health Systems > Surveillance, monitoring & evaluation
Divisions: Muhimbili University of Health and Allied Sciences (MUHAS)
Depositing User: Mr Joseph Madata
Date Deposited: 07 Feb 2013 08:50
Last Modified: 07 Feb 2013 08:50
URI: http://ihi.eprints.org/id/eprint/1022

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