Automated DXA-based finite element analysis for hip fracture risk stratification: a cross-sectional study
| Autor: | Yunhua Luo, Shuman Yang, William D. Leslie, Sharif Ahmed, I. Delubac, Linda M. Ward, Andrew L. Goertzen, Lisa M. Lix |
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| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
0301 basic medicine medicine.medical_specialty FRAX Endocrinology Diabetes and Metabolism Population Osteoporosis Finite Element Analysis 030209 endocrinology & metabolism Risk Assessment 03 medical and health sciences 0302 clinical medicine Absorptiometry Photon Bone Density medicine Humans Registries education Dual-energy X-ray absorptiometry Osteoporosis Postmenopausal Femoral neck Aged Bone mineral Orthodontics Aged 80 and over education.field_of_study Hip fracture medicine.diagnostic_test business.industry Femur Neck Hip Fractures Manitoba medicine.disease medicine.anatomical_structure Cross-Sectional Studies Orthopedic surgery Female Hip Joint 030101 anatomy & morphology business Osteoporotic Fractures |
| Zdroj: | Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 29(1) |
| ISSN: | 1433-2965 |
| Popis: | Fracture risk indices (FRIs) generated from DXA-based finite element analysis were associated with hip fracture independent of FRAX score computed with femoral neck bone mineral density (BMD). Prospective studies are warranted to determine whether FRIs represent an improvement over BMD for predicting incident hip fractures. The study aims to examine the association between prior hip fracture and FRIs derived from automated finite element analysis (FEA) of DXA hip scans. Femoral neck, intertrochanteric, and subtrochanteric FRIs were calculated as the von Mises stress induced by a sideways fall divided by the bone yield stress over the specified region of interest (ROI). Using the Manitoba Bone Mineral Density Database, we selected women age ≥ 65 years with femoral neck T-scores below − 1 and no osteoporosis treatment. From this population, we identified 324 older women with hip fracture before DXA testing and a random sample of 658 non-fracture controls. FRIs were derived from the anonymized DXA scans. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the associations between FRIs (per SD increase) and hip fracture. After adjusting for FRAX score (hip fracture with BMD), femoral neck FRI (OR 1.36, 95% CI 1.13, 1.64), intertrochanteric FRI (OR 1.81, 95% CI 1.44, 2.27), and subtrochanteric FRI (OR 2.09, 95% CI 1.68, 2.60) were associated with hip fracture. Intertrochanteric and subtrochanteric FRIs gave significantly higher c-statistics (all P ≤ 0.05) than femoral neck BMD. Subgroup analyses showed that all FRIs were more strongly associated with hip fracture in women who were younger and had higher body mass index (BMI) or non-osteoporotic BMD (all P interaction |
| Databáze: | OpenAIRE |
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