Development of fracture risk assessment scale for children (adults) with severe motor and intellectual disabilities.

Abstract

We developed a fracture risk assessment scale with which facture risk for children (adults) with severe motor and intellectual disabilities (SMID) can be predicted. A significance test was conducted in patients with fractures and patients without fractures for factors which might be associated with fractures observed at our hospital. According to the results, the following 7 factors were extracted as the fracture risk factors: Age of 50 or older, Female patients aged 50 or older, Mobility function levels 2, 3 and 4 of Yokochi classification, Intellectual development levels B and C of Yokochi classification, Past history of having a fracture, Oral administration of enzyme-induced antiepileptic drugs, and Bone density of 40% or less. We distributed scores of 1-3 to these risk factors according to the level of incidence of fractures associated with these factors and then developed a fracture assessment scale with which we could predict presence or absence of fracture risks from the total score of each one of the risk factors. Consequently, we were able to predict that a patient with a total score of 6 or above for these factors might have the risk of fracture. In a hospital with high percentage of such children (adults) with SMID as in our case, it is beneficial to use this scale to prevent fracture as it enables staff members of the team to make standardized evaluations on users, leading to sharing of users' information and improvement in a sense of professionalism.