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Objective: To compared Fracture Risk Assessment Tool (FRAX) score in previous hip fracture patients with type 2 diabetes and non-diabetes patients and to ascertain accuracy of FRAX whether using Rheumatoid Arthritis (RA) substitution of diabetes.
Methods: A retrospective study from medical record in patients aged 50 to 100 years with previous osteoporotic hip fracture in Vajira hospital between January 1st, 2014 to January 31st, 2019. Comparing mean of FRAX score between type 2 diabetes and non-diabetes group.
Results: A total of 288 participants with previous osteoporotic hip fracture were included in the study, type 2 diabetes (T2DM) 144 patients (50.88%) and non-diabetic 139 patients (49.12%). The significant lower FRAX score between diabetic and control group was observed for both major osteoporotic (MOF) 6.68±4.66 vs. 8.53±5.26, p = 0.02 and hip fracture (HF) 2.42±2.69 vs. 3.96±3.71, p<0.01 respectively. Adjusted FRAX by substitution RA input for diabetes, the fracture risk estimates in both groups were approximately (MOF 9.09±6.32 vs. 8.53±5.26, p = 0.412 and HF 3.87±4.05 vs. 3.96±3.71, p = 0.888)
Conclusions: The FRAX tool underestimated fracture risk in T2DM compared to non-diabetes patients. The introduction of a correction factor by selecting RA as equivalent variable for T2DM resulted in mean FRAX values no longer significant to those without diabetes subjects which can improve the performance of the FRAX prediction.
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