FRAX (FRACTURE RISK ASSESSMENT TOOL) PREDICTION WITHOUT BMD (BONE MINERAL DENSITY) FOR ASSESSMENT OF OSTEOPOROTIC FRACTURE RISK IN THE GENERAL POPULATION OF PESHAWAR

Objective: To identify fracture risk assessment without using bone mineral density in assessing osteoporotic fracture risk using a FRAX prediction model among the general population of Peshawar. Materials and Methods: A descriptive cross-sectional study was conducted from January to June 2024 among adults aged 40 and older residing in Peshawar. A sample of 240 was selected through a multistage sampling technique. Inclusion criteria were those who were residents in Peshawar and were willing to participate, and those having chronic illnesses like liver disease, cancer, or kidney disease were excluded. The FRAX tool was implemented after informed verbal consent. Data was analysed using SPSS version 20. The fracture probability was calculated and stratified according to relevant demographic and clinical factors. Results: Among 240 participants, 39 (16.4%) had osteoporosis, of which 12 (4.8%) and 27 (11.6%) were males and females, respectively. Risk factors included previous fractures (31.2%), smoking (15.6%), steroid use (17.2%), rheumatoid arthritis (8.8%), and secondary osteoporosis (20.4%). Hip fracture risk was low in 191 (79.6%), moderate in 33 (13.6%), high in 12 (5.2%), and very high in 4 (1.6%). For major osteoporotic fractures, 194 (80.8%) had low risk, 31 (13.2%) had moderate risk, 9 (3.6%) had high risk, and 6 (2.4%) had very high risk. Females had a higher probability of major osteoporotic fractures (3.05) and hip fractures (0.67) compared to males (2.14 and 0.48, respectively). A statistically significant association was observed between gender and major osteoporotic fracture risk (p = 0.005). Conclusion: Osteoporosis among adults aged 40 and above in Peshawar is high, with women being affected more. This highlights the importance of early risk assessment and timely intervention to prevent complications. Keywords: Osteoporosis, Bone mineral density, Fracture risk assessment, Major Osteoporotic Fracture, Hip Fracture.