Cargando…

Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients

BACKGROUND: Radiographic parameters and indices obtained from hip x-rays are a potential tool to promptly estimate bone quality in elderly hip fracture patients. Preoperative decision in whether to use cemented or cement augmented implants might be supported by this information and thus improve pati...

Descripción completa

Detalles Bibliográficos
Autores principales: Yeo, Andy K. S., Ahrberg, Annette B, Theopold, Jan D., Ewens, Sebastian, Borte, Gudrun, Josten, Christoph, Fakler, Johannes K. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658799/
https://www.ncbi.nlm.nih.gov/pubmed/26609325
http://dx.doi.org/10.1186/s13037-015-0085-2
_version_ 1782402571960320000
author Yeo, Andy K. S.
Ahrberg, Annette B
Theopold, Jan D.
Ewens, Sebastian
Borte, Gudrun
Josten, Christoph
Fakler, Johannes K. M.
author_facet Yeo, Andy K. S.
Ahrberg, Annette B
Theopold, Jan D.
Ewens, Sebastian
Borte, Gudrun
Josten, Christoph
Fakler, Johannes K. M.
author_sort Yeo, Andy K. S.
collection PubMed
description BACKGROUND: Radiographic parameters and indices obtained from hip x-rays are a potential tool to promptly estimate bone quality in elderly hip fracture patients. Preoperative decision in whether to use cemented or cement augmented implants might be supported by this information and thus improve patient safety. Subsequently, this study was conducted to evaluate radiographic parameters as a prescreening tool for bone quality. METHODS: A retrospective analysis of 112 elderly patients with a femoral neck fracture after low-energy trauma was performed (81 % female, 19 % male). Three radiological indices were calculated on hip x-rays: cortical index antero-posterior CTI (ap), cortical index lateral CTI (lat) and canal to calcar ratio CCR. These indices were analyzed for correlations with DXA T-Scores and serum 25-hydroxyvitamin D (25(OH)D) using the Spearman test. RESULTS: Median age of patients was 80 (IQR 72–86) years. A linear correlation was found for CTI (lat) and T-Score at the total hip (p < 0.001, r = 0.589), femoral neck (p = 0.005, r = 0.405) and the lumbar spine (p = 0.002, r = 0.299). A significant correlation was also indicated between CTI (lat) and 25(OH)D (p = 0.002, r = 0.293). CTI (lat) at a cut-off level of 0.4 showed a sensitivity of 79 % and a specificity of 56 % in predicting a T-score ≤ −2.5 at the total hip. Gender specific analysis revealed a higher sensitivity (100 %) and specificity (73 %) of CTI (lat) at a cut-off level of 0.4 for men. For severe vitamin D deficiency (<10 ng/ml) sensitivity and specificity were 75 % and 65 %. CONCLUSION: Radiographic indices as the CTI (lat) exhibit a direct correlation to BMD and serum 25OH vitamin D levels. A CTI (lat) cut-off level of 0.4 is recommended for identifying patients at risk of osteoporosis expressed by T-Scores ≤ −2.5 and severe vitamin D deficiency.
format Online
Article
Text
id pubmed-4658799
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-46587992015-11-26 Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients Yeo, Andy K. S. Ahrberg, Annette B Theopold, Jan D. Ewens, Sebastian Borte, Gudrun Josten, Christoph Fakler, Johannes K. M. Patient Saf Surg Research BACKGROUND: Radiographic parameters and indices obtained from hip x-rays are a potential tool to promptly estimate bone quality in elderly hip fracture patients. Preoperative decision in whether to use cemented or cement augmented implants might be supported by this information and thus improve patient safety. Subsequently, this study was conducted to evaluate radiographic parameters as a prescreening tool for bone quality. METHODS: A retrospective analysis of 112 elderly patients with a femoral neck fracture after low-energy trauma was performed (81 % female, 19 % male). Three radiological indices were calculated on hip x-rays: cortical index antero-posterior CTI (ap), cortical index lateral CTI (lat) and canal to calcar ratio CCR. These indices were analyzed for correlations with DXA T-Scores and serum 25-hydroxyvitamin D (25(OH)D) using the Spearman test. RESULTS: Median age of patients was 80 (IQR 72–86) years. A linear correlation was found for CTI (lat) and T-Score at the total hip (p < 0.001, r = 0.589), femoral neck (p = 0.005, r = 0.405) and the lumbar spine (p = 0.002, r = 0.299). A significant correlation was also indicated between CTI (lat) and 25(OH)D (p = 0.002, r = 0.293). CTI (lat) at a cut-off level of 0.4 showed a sensitivity of 79 % and a specificity of 56 % in predicting a T-score ≤ −2.5 at the total hip. Gender specific analysis revealed a higher sensitivity (100 %) and specificity (73 %) of CTI (lat) at a cut-off level of 0.4 for men. For severe vitamin D deficiency (<10 ng/ml) sensitivity and specificity were 75 % and 65 %. CONCLUSION: Radiographic indices as the CTI (lat) exhibit a direct correlation to BMD and serum 25OH vitamin D levels. A CTI (lat) cut-off level of 0.4 is recommended for identifying patients at risk of osteoporosis expressed by T-Scores ≤ −2.5 and severe vitamin D deficiency. BioMed Central 2015-11-25 /pmc/articles/PMC4658799/ /pubmed/26609325 http://dx.doi.org/10.1186/s13037-015-0085-2 Text en © Yeo et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Yeo, Andy K. S.
Ahrberg, Annette B
Theopold, Jan D.
Ewens, Sebastian
Borte, Gudrun
Josten, Christoph
Fakler, Johannes K. M.
Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients
title Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients
title_full Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients
title_fullStr Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients
title_full_unstemmed Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients
title_short Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients
title_sort are radiographic indices reliable indicators for quantitative bone mineral density and vitamin d status after femoral neck fractures? a retrospective study in 112 elderly patients
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658799/
https://www.ncbi.nlm.nih.gov/pubmed/26609325
http://dx.doi.org/10.1186/s13037-015-0085-2
work_keys_str_mv AT yeoandyks areradiographicindicesreliableindicatorsforquantitativebonemineraldensityandvitamindstatusafterfemoralneckfracturesaretrospectivestudyin112elderlypatients
AT ahrbergannetteb areradiographicindicesreliableindicatorsforquantitativebonemineraldensityandvitamindstatusafterfemoralneckfracturesaretrospectivestudyin112elderlypatients
AT theopoldjand areradiographicindicesreliableindicatorsforquantitativebonemineraldensityandvitamindstatusafterfemoralneckfracturesaretrospectivestudyin112elderlypatients
AT ewenssebastian areradiographicindicesreliableindicatorsforquantitativebonemineraldensityandvitamindstatusafterfemoralneckfracturesaretrospectivestudyin112elderlypatients
AT bortegudrun areradiographicindicesreliableindicatorsforquantitativebonemineraldensityandvitamindstatusafterfemoralneckfracturesaretrospectivestudyin112elderlypatients
AT jostenchristoph areradiographicindicesreliableindicatorsforquantitativebonemineraldensityandvitamindstatusafterfemoralneckfracturesaretrospectivestudyin112elderlypatients
AT faklerjohanneskm areradiographicindicesreliableindicatorsforquantitativebonemineraldensityandvitamindstatusafterfemoralneckfracturesaretrospectivestudyin112elderlypatients