Osteoporotic Hip Fracture Prediction: Is T-Score-Based Criterion Enough? A Hip Structural Analysis-Based Model
Autor: | Alberto Audenino, Alessandra Aldieri, Alberto Angeli, Andrea Veltri, Mara Terzini, Cristina Bignardi, G. Osella, Adriano Massimiliano Priola |
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Rok vydání: | 2018 |
Předmět: |
0206 medical engineering
Osteoporosis Biomedical Engineering 030209 endocrinology & metabolism HSA 02 engineering and technology Standard score 03 medical and health sciences 0302 clinical medicine FE model hip fracture multivariate linear regression analysis osteoporosis Physiology (medical) Bayesian multivariate linear regression Statistics medicine Risk factor Mathematics Hip fracture Biomechanics Regression analysis medicine.disease 020601 biomedical engineering Akaike information criterion |
Zdroj: | Journal of biomechanical engineering. 140(11) |
ISSN: | 1528-8951 |
Popis: | At present, the current gold-standard for osteoporosis diagnosis is based on bone mineral density (BMD) measurement, which, however, has been demonstrated to poorly estimate fracture risk. Further parameters in the hands of the clinicians are represented by the hip structural analysis (HSA) variables, which include geometric information of the proximal femur cross section. The purpose of this study was to investigate the suitability of HSA parameters as additional hip fracture risk predictors. With this aim, twenty-eight three-dimensional patient-specific models of the proximal femur were built from computed tomography (CT) images and a sideways fall condition was reproduced by finite element (FE) analyses. A tensile or compressive predominance based on minimum and maximum principal strains was determined at each volume element and a risk factor (RF) was calculated. The power of HSA variables combinations to predict the maximum superficial RF values was assessed by multivariate linear regression analysis. The optimal regression model, identified through the Akaike information criterion (AIC), only comprises two variables: the buckling ratio (BR) and the neck-shaft angle (NSA). In order to validate the study, the model was tested on two additional patients who suffered a hip fracture after a fall. The results classified the patients in the high risk level, confirming the prediction power of the adopted model. |
Databáze: | OpenAIRE |
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