Risk Estimates for Hip Fracture From Clinical and Densitometric Variables and Impact of Database Selection in Lebanese Subjects

Badra, Mohammad; Mehio-Sibai, Abla; Zeki Al-Hazzouri, Adina; Abou Naja, Hala; Baliki, Ghassan; Salamoun, Mariana; Afeiche, Nadim; Baddoura, Omar; Bulos, Suhayl; Haidar, Rachid; Lakkis, Suhayl; Musharrafieh, Ramzi; Nsouli, Afif; Taha, Assaad; Tayim, Ahmad; El-Hajj Fuleihan, Ghada

doi:10.1016/j.jocd.2009.01.003

« Previous Next »Journal of Clinical Densitometry
Volume 12, Issue 3 , Pages 272-278, July 2009

Risk Estimates for Hip Fracture From Clinical and Densitometric Variables and Impact of Database Selection in Lebanese Subjects

Mohammad Badra
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Abla Mehio-Sibai
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
Adina Zeki Al-Hazzouri
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
Hala Abou Naja
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
Ghassan Baliki
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
Mariana Salamoun
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
Nadim Afeiche
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Omar Baddoura
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Suhayl Bulos
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Rachid Haidar
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Suhayl Lakkis
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Ramzi Musharrafieh
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Afif Nsouli
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Assaad Taha
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Ahmad Tayim
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
Ghada El-Hajj Fuleihan
- Address correspondence to: Ghada El-Hajj Fuleihan, MD, MPH, Calcium Metabolism and Osteoporosis Program, Department of Internal Medicine, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon.
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon

Received 3 November 2008; received in revised form 13 January 2009; accepted 13 January 2009. published online 02 March 2009.

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 74yr (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.