FRAX联合STRATIFY跌倒评估量表预测养老机构老年人骨质疏松性骨折发生风险研究

Predicting Osteoporotic Fracture Risk in Nursing Home Residents: A Study Combining FRAX and the STRATIFY Fall Assessment Scale

摘要: 目的：本研究旨在探讨FRAX联合STRATIFY跌倒评估量表对养老机构老年人骨质疏松性骨折发生风险的预测价值，并对高风险或中风险者的干预提供有效建议。方法：研究纳入320名养老机构老年人，应用FRAX联合STRATIF量表对养老机构老年人进行评估，结合骨折发生情况，建立FRAX联合STRATIF的骨质疏松性骨折风险预测模型。采用SPSS 21.0进行χ²检验和非参数检验进行单因素分析，计算FRAX工具和跌倒评估量表评分的ROC特征曲线下面积，确定最佳预测效能。结果：符合纳入标准的320名养老机构老年人，女性182人，男性138人，平均年龄为77.62 ± 4.07岁。是否发生骨折2组对象间FRAX风险因子、跌倒风险因子存在差异。FRAX工具ROC曲线下面积AUC = 0.738；跌倒风险量表ROC曲线下面积AUC = 0.776；两者联合ROC曲线下面积AUC = 0.844。结论FRAX联合STRATIFY跌倒评估量表预测模型具有较好的预测效能，可有效预测养老机构老年人骨质疏松性骨折发生风险。

Abstract: Objective: This study aimed to explore the predictive value of combining the FRAX tool with the STRATIFY Fall‑Risk Assessment Scale for the risk of osteoporotic fractures among older adults in nursing homes, and to provide evidence‑based suggestions for interventions targeting participants at high‑ or moderate‑risk levels. Methods: A total of 320 older adults from nursing homes were enrolled in this study. The FRAX tool combined with the STRATIFY scale was adopted for risk assessment. A prediction model for osteoporotic fracture risk was established based on fracture outcomes. SPSS 21.0 software was used for univariate analyses including the χ² test and non‑parametric test. The area under the receiver operating characteristic (ROC) curve was calculated for the FRAX tool and the fall‑risk scale to determine the optimal predictive performance. Results: Among the 320 eligible older adults (182 females and 138 males), the mean age was 77.62 ± 4.07 years. Significant differences in FRAX‑derived risk factors and fall‑risk factors were observed between the fracture group and the non‑fracture group. The area under the ROC curve (AUC) was 0.738 for the FRAX tool, 0.776 for the fall‑risk scale, and 0.844 for the combined model. Conclusion: The prediction model combining FRAX and the STRATIFY Fall‑Risk Assessment Scale exhibits satisfactory predictive performance and can effectively predict the risk of osteoporotic fractures in institutional‑dwelling older adults.