Predicting a second hip fracture - The potential role of dual X-ray absorptiometry, ultrasound, and other risk factors in targeting of preventive therapy

A Stewart, L G Walker, R W Porter, D M Reid, W R Primrose

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

In an attempt to identify a high-risk cohort of patients, who could be offered preventive therapy, we assessed of patients who had suffered one hip fracture. A total of 394 patients were prospectively followed to determine those who had suffered a second fracture. Entry bone mass of the unfractured hip and total body was examined by dual X-ray absorptiometry (DXA) and of the os calcis, by quantitative ultrasound (QUS), along with various clinical parameters. The relative risks in the QUS parameters did not reach significance, except for broadband ultrasound attenuation as measured by the McCue CUBA Clinical, whereas femoral neck and total body bone mineral density also reached significance. Lowest quartile body weight was also a significant risk factor as were occurrence of a new fall and poor mobility score. Using Receiver Operator Characteristic curves, we found no significant differences between DXA trochanter or for the Mini Mental State Examination score in predicting those who sustained a second hip fracture. In this elderly group risk factors are almost as good as bone mass at predicting those who will sustain a second hip fracture. Low body weight and poor mobility could be used as triggers for the use of preventive therapy without the use of bone mass measurements and to target expensive preventive therapy to reduce fracture risk.

Original languageEnglish
Pages (from-to)363-370
Number of pages8
JournalJournal of Clinical Densitometry
Volume2
Publication statusPublished - 1999

Keywords

  • dual X-ray absorptiometry
  • falls
  • hip fractures
  • osteoporosis
  • quantitative ultrasound
  • low body weight
  • POSTMENOPAUSAL OSTEOPOROSIS
  • ELDERLY WOMEN
  • BONE
  • ALENDRONATE

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