Fracture Risk for Women with Known Bone Mineral Density (BMD)

The Fracture Index with known Bone Mineral Density (BMD) estimates 5-year vertebral, non-vertebral, and hip fracture risk for female patients with historical and radiographic information surrounding their bone health. This clinical decision tool was derived by Black et al. (2001) through an assessment of 7782 women who were followed as a cohort for many years. Through a demographic assessment, age analysis, and DXA scanning for BMD, the predictive variables as associated risks were derived.
There have subsequently been other fracture risk calculators (eg. FRAX, FRAMO) that involve other combinations of medical history, exam, and radiographic features, though some tools do not utilize BMD to increase clinical applicability at the bedside. Notably, the authors for the Fracture Index have also published predictive data if BMD was excluded from the analysis.
Variable & Associated Points
Patient Age If < 65 = 0 points If 65 - 69 = 1 point If 70 - 74 = 2 points If 75 - 79 = 3 points If 80 - 84 = 4 points If ≥ 85 = 5 points
Bone Mineral Density If value ≥ -1 (0 points) If value ≥ -2 up to but not including -1 (2 points) If value ≥ -2.5 up to but not including -2 (3 points) If ≤ - 2.5 (4 points) Patient has had fractures after age 50 (Yes +1, No 0)
Patient’s mother has had a hip fracture after age 50 (Yes +1, No 0)
Patient body weight is less than 125lbs (56.6kg) (Yes +1, No 0)
Patient is an active smoker (Yes +1, No 0
Patient requires arm assistance to stand from chair (Yes +2, No 0)

See Black et al. 2001 for associated 5-Year Fracture Risk profiles based on total score.