Abstract 174: Assessment of discordant rates and its influencing factors in suggested management outcomes by utilizing prediction model of FRAX with BMD versus FRAX without BMD

Objective: To compare concordance/discordance rates in prediction model of 10-year probability of hip and major osteoporoticfractures (MOF) utilizing Fracture Risk Assessment Tool (FRAX) calculations with and withoutbone mineral density (BMD). Furthermore, we aim to characterize difference in various parameters between concordant and discordant groups based on above prediction tool. Method: A retrospective review of patients who underwent BMD measurement and FRAX assessment was conducted. Patients > 40 years were included and FRAX prediction scores were calculated with and without BMD using the FRAX India tool. Subjects were separated on the basis of identical and different treatment recommendations. Fracture risk factors were compared between groups using simple Student's t test analysis of numerical variables and Fisher's exact test analysis of binary variables. Results: Out of total 354 subjects, 285 (80.50%) had similar management outcomes with or without BMD in FRAX estimation. The discordant group had a higher mean age (63.1 years; p <0.00024) with similar BMI status. Glucocrticoid use was significantly more prevalent in discordant group (40.5% vs. 27.7%; p <0.03) whereas history of parent hip fracture was more frequent in concordant group (11.6% vs. 2.9%; p <0.03). Conclusion: In most cases, FRAX alone provided the same prediction as FRAX with BMD in fracture prediction models required for management recommendation in majority of cases in our cohort. Older age and priorglucocorticoid use are more frequently seen in discordant group whereas prevalence of parent hip fracture was common in concordant group.