THU0501 What does trabecular bone score contribute to a fracture liaison service

Background The utility of the trabecular bone score (TBS) is controversial. Objectives To analyse the clinical usefulness of FRAX-TBS in patients with fragility fracture seen in a Fracture Liaison Service (FLS) compared to FRAX without TBS. Methods Consecutive outpatients >50 y seen in our FLS were included, excluding patients admitted with hip fracture. The variables included were: age, sex, type of fracture, risk factors for FRAX, FRAX for major and hip fractures with and without TBS, bone densitometry (DXA) and indication of treatment to prevent new fractures. Results We included 251 patients, mean age 69 y, 86% women. The most frequent type of fracture was the forearm (n=122) followed by the humerus (n=64). The DXA scan results (taking the lowest value of column/hip) was osteoporosis in 41%. The average TBS was 1.307 (SD 0.103, range 0.961–1.550): forearm fracture 1.313 (SD 0.102), vertebra 1.281 (SD 0.131) and hip 1.291 (SD 0.103). 32% presented normal TBS result 53% partially degraded and 15% degraded (table 1). The results of FRAX with and without TBS were similar, with an average for major/hip fracture of 10.7/4.2 with DXA and 10.6/4.0 with TBS respectively (p>0.05). A high risk of hip fracture (FRAX ≥3) was observed in 43% of patients using FRAX-DXA and 41% using FRAX-TBS. Ans a high risk of major fracture (FRAX ≥10) in 40% of patients using FRAX-DXA and 41% using FRAX-TBS. In 241 cases (96%) there was concordance in level of risk for FRAX-DXA and FRAX-TBS, while the 10 discordant cases for high risk of fracture were distributed as follows: in 6 cases FRAX-DXA was high and FRAX-TBS was normal, and in 4 cases FRAX-DXA was normal and FRAX-TBS was elevated. In our FLS, a bisphosphonate was prescribed to 169 patients (67%). Regarding patients with a low FRAX risk (n=82), in one patient FRAX-TBS was in favour of treatment. Thus, in 1/251 fractures FRAX-TBS could have influenced the treatment indication compared to FRA-DXA. Conclusions In our FLS unit, TBS does not help to classify patients‘ risk. The values of FRAX-TBS are similar to those of FRAX-DXA, not offering advantages when classifying patients with high risk who are candidates for treatment. Disclosure of Interest None declared