Differences in Femoral Neck and Trochanteric Structure in Elderly Women Prior to Hip Fracture: Role in Hip Fracture Prediction
Authors' conclusion
In conclusion, adding measurement of FN Delta, an assessment of superior sector bone loss, to hip aBMD and age substantially improved clinical FNF prediction in older women.
Study context
- Population
- Elderly women, mean age (SD) 75 (3) years, Perth Longitudinal Study of Aging in Women
- Participants
- 1,151 women
- Exposure
- Women who later sustained femoral neck fracture (FNF) or trochanter fracture (TRF) vs those who did not fracture
- FNFn = 69
- TRFn = 59
- Outcome
- Improvement of FNF and TRF prediction by internal DXA structural variables (Sigma, Delta, width) added to aBMD
Methodological details14.5-year longitudinal study, baseline hip DXA
- 14.5-year longitudinal study
- Baseline hip DXA
Main finding
As reported in the abstract
FNF prediction (Cox analysis)
- HR age
- 1.39
- HR total hip areal BMD (aBMD)
- 0.79
- HR Delta
- 1.70
- C statistic, total hip aBMD (THaBMD) + age vs + femoral neck (FN) Delta
- 0.62 to 0.69, p = 0.01
- Baseline FNF vs nonfracture: FNaBMD lower
- 7%
- Baseline FNF vs nonfracture: FNWidth higher
- 3%
- Baseline FNF vs nonfracture: FNDelta higher
- 29%
Observational data: associations, not effects.
Further findings
TRF prediction
- Baseline TRF vs nonfracture: TRaBMD lower
- 15%
- Difference in Sigma
- 1%
- Difference in Width
- 2%
- Neither Sigma nor Width improved the age + THaBMD model; C-statistic unchanged
- 0.81
Original publication
Differences in Femoral Neck and Trochanteric Structure in Elderly Women Prior to Hip Fracture: Role in Hip Fracture Prediction. J Bone Miner Res. Published 16 February 2023. doi:10.
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