Relevance of vertebral fractural deformity for hip fracture prediction: a community-based study of older Chinese women and men.

objectiveTo estimate hip fracture (Fx) risk if one or more vertebral fractures are detected in an otherwise healthy older woman or man. MATERIALS AND

methodsThe study was conducted among older Chinese community subjects. 2000 women were enrolled; 1951 were followed for five years. 2000 men were enrolled; 1882 cases were followed for five years. With thoracolumbar spine radiographs, for each vertebra, a score of 0, -0.5, -1, -1.5, -2, -2.5, and -3 was assigned for no osteoporotic-like vertebral fractural deformity (OLVF) or OLVF of < 20%, ≥ 20 ~ 25%, ≥ 25% ~ 33%, ≥ 33% ~ 40%, ≥ 40% ~ 66%, and ≥ 66% vertebral height loss, respectively. OLVFss was the summed score of vertebrae T3 to L5. The femoral neck (FN) cutpoint T-score was ≤ -2.7 for osteoporosis in women and ≤ -2.1 for osteofrailia in men. OLVFss ≤  - 1.5 suggests osteoporosis in women, and OLVFss ≤  - 2.5 suggests osteofrailia in men.

resultsFor women, 26 cases developed hip Fx (mean age: 80 years). Baseline FN T-score ≤ -2.7 and OLVFss ≤ -1.5 had a positive predictive value of 5.22% and 5.05%, and a detection sensitivity of 65.38% and 53.85%, respectively. For men, 23 cases developed hip Fx (mean age: 81 years). Baseline FN T-score ≤ -2.1 and OVLFss ≤ -2.5 had a positive predictive value of 4.24% and 4.81%, and a detection sensitivity of 52.17% and 21.74%, respectively.

conclusionCompared with FN T-score thresholds, OVLFss had a similar performance for future hip Fx risk estimation for women, for men OVLFss had a similar positive predictive value for future hip Fx risk but was associated with a lower detection sensitivity.