Epidemiology of osteoporotic fracture in Moldova and development of a country-specific FRAX model

Abstract

Retrospective population-based survey in 2 regions of the Republic of Moldova determined the incidence of fractures at the hip, proximal humerus and distal forearm. The estimated number of such fractures nationwide for 2015 was 11,271 and is predicted to increase to 15,863 in 2050. The hip fracture rates were used to create a FRAX model to help guide decisions about treatment. Objective This paper describes the epidemiology of osteoporotic fractures in Republic of Moldova that was used to develop the country-specific fracture prediction FRAX® tool. Methods We carried out a retrospective population-based survey in 2 regions of the Republic of Moldova (Anenii Noi district and Orhei district) representing approximately 6% of the country's population. We identified hip, forearm and humerus fractures in 2011 and 2012 from hospital registers and primary care sources. Age-and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Moldova. Fracture probabilities were compared with those from neighbouring countries having FRAX models. Results The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 3911 and is predicted to increase by 60% to 6492 in 2050. Hip fracture incidence was a good predictor of forearm and humeral fractures. FRAX-based probabilities were higher in Moldova than neighbouring countries (Ukraine and Romania). Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Moldavan population and help guide decisions about treatment.

Epidemiology of hip fractures in Bulgaria: development of a country-specific FRAX model

“…Thereafter, incidence was higher in women. Similar results have been reported in many studies including other countries in Eastern Europe, namely Russia [12], Armenia [11], Moldova [14] and Belarus, [13]. From these results, Bulgaria belongs to the moderate risk countries for osteoporotic hip fracture for men and women [28].…”

“…This assumption has been used for many of the FRAX models with incomplete epidemiological information on non-hip fractures. Available information suggests that the age-and sex-stratified pattern of fracture is very similar in the Western world and Australia [14,[18][19][20].…”

“…In order to compare Bulgarian hip fracture probabilities with those of other regions of the world, the remaining lifetime probability of hip fracture from the age of 50 years was calculated for men and women as described by Kanis et al [22]. In the present analysis, values for Bulgaria were compared with those of China (with and without inclusion of Hong Kong), Canada, Denmark, Finland, France, Greece, Hungary, Portugal, Spain, Sweden, UK and the USA [22], with more recent additions from Mexico [23], Romania [24], Poland [25], Moldova [14], Russia [12], Turkey [10], Ukraine [26] and Serbia [27].…”

“…The availability of FRAX has stimulated studies for the generation of new FRAX models. Specific examples include Brazil, Mexico, Turkey [8][9][10] and several countries in Eastern Europe [11][12][13][14]. The present report describes the epidemiology of fractures at the hip in Bulgaria and the generation of a country-specific FRAX model.…”

Epidemiology of osteoporotic fracture in Kazakhstan and development of a country specific FRAX model

“…The present study is a component part of the Multicenter Multinational population-based Study in Eurasian Countries (EVA study or ЭВА, in Russian). The broad aim of the study was to provide epidemiological information on fracture risk so that FRAX models could be created for Russia [9], Armenia [10], Belarus [11], Moldova [12], Kazakhstan and Uzbekistan. The present report describes the epidemiology of fractures at the hip, forearm and humerus in Kazakhstan and the generation of a country specific FRAX model.…”