title: Risk estimates for hip fracture from clinical and densitometric variables and impact of database selection in Lebanese subjects.
abstract: Bone mineral density (BMD) and fracture incidence vary greatly worldwide. The data, if any, on clinical and densitometric characteristics of patients with hip fractures from the Middle East are scarce. The objective of the study was to define risk estimates from clinical and densitometric variables and the impact of database selection on such estimates. Clinical and densitometric information were obtained in 60 hip fracture patients and 90 controls. Hip fracture subjects were 74 yr (9.4) old, were significantly taller, lighter, and more likely to be taking anxiolytics and sleeping pills than controls. National Health and Nutrition Examination Survey (NHANES) database selection resulted in a higher sensitivity and almost equal specificity in identifying patients with a hip fracture compared with the Lebanese database. The odds ratio (OR) and its confidence interval (CI) for hip fracture per standard deviation (SD) decrease in total hip BMD was 2.1 (1.45-3.05) with the NHANES database, and 2.11 (1.36-2.37) when adjusted for age and body mass index (BMI). Risk estimates were higher in male compared with female subjects. In Lebanese subjects, BMD- and BMI-derived hip fracture risk estimates are comparable to western standards. The study validates the universal use of the NHANES database, and the applicability of BMD- and BMI-derived risk fracture estimates in the World Health Organization (WHO) global fracture risk model, to the Lebanese.
authors.affiliation: Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Badra
authors.forename: Abla
authors.initials: A
authors.lastname: Mehio-Sibai
authors.forename: Adina
authors.initials: A
authors.lastname: Zeki Al-Hazzouri
authors.forename: Hala
authors.initials: H
authors.lastname: Abou Naja
authors.forename: Ghassan
authors.initials: G
authors.lastname: Baliki
authors.forename: Mariana
authors.initials: M
authors.lastname: Salamoun
authors.forename: Nadim
authors.initials: N
authors.lastname: Afeiche
authors.forename: Omar
authors.initials: O
authors.lastname: Baddoura
authors.forename: Suhayl
authors.initials: S
authors.lastname: Bulos
authors.forename: Rachid
authors.initials: R
authors.lastname: Haidar
authors.forename: Suhayl
authors.initials: S
authors.lastname: Lakkis
authors.forename: Ramzi
authors.initials: R
authors.lastname: Musharrafieh
authors.forename: Afif
authors.initials: A
authors.lastname: Nsouli
authors.forename: Assaad
authors.initials: A
authors.lastname: Taha
authors.forename: Ahmad
authors.initials: A
authors.lastname: Tayim
authors.forename: Ghada
authors.initials: G
authors.lastname: El-Hajj Fuleihan
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006620:Hip Fractures / Q000208:ethnology*; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology*; D018579:Patient Selection; D012307:Risk Factors