Is time since hip fracture influencing the discrimination between fractured and nonfractured subjects as assessed at the calcaneum by three technologically different quantitative ultrasound devices?

Article Article scientifique Article Is time since hip fracture influencing the discrimination between fractured and nonfractured subjects as assessed at the calcaneum by three technologically different quantitative ultrasound devices? eng 2002 author Hans Didier 135251 author Allaoua Samia 100496 author Genton Graf Laurence 0000-0002-0037-5203 514243 author Delmi Marino 31561 author Vuagnat Hubert Blaise 32942 author Rizzoli René 22717 author Tahintzi-Zawadynski S author Perron Christine 26060 author Pichard Claude 21908 author Slosman Daniel 28416 485-492 10.1007/s00223-002-2005-6 12232682 0171-967X Because quantitative ultrasound (QUS) instruments from different manufacturers have significant technical differences, it is difficult to assess whether all of them can discriminate similarly between osteoporotic fractures and age-matched controls. Thus, to avoid any bias, reliable comparative assessment of the QUS devices should be carried out on the same population. Few studies have fulfilled this condition. Another source of variability in cross-sectional studies in which fractured and nonfractured subjects are compared is the time since osteoporotic fracture. Our study evaluated the ability of three calcaneal QUS devices to discriminate patients with osteoporotic hip fracture from control subjects, using the same population. In addition, a subset of patients was re-measured about 9 months after the hip replacement surgery to check how the time since fracture affects the discriminatory ability of the different QUS devices. Fifty postmenopausal hip-fractured patients and 46 postmenopausal age-matched controls were included in this study and measured on three QUS devices, as well as 50 young healthy controls to calculate the T-score. Odds ratio results showed that a decrease in UBIS trade mark BUA of 1 SD was associated with a significant increase in fracture risk (odds ratio adjusted = 2.30) comparable with Sahara broadband ultrasound attenuation (BUA) (OR adj. = 2.30), and Achilles BUA (OR adj. = 3.5). However, given the large overlap between the 95% intervals of each OR and for the areas under ROC curves, no significant difference was found between them. In the subset of 15 hip-fractured subjects, no significant differences were found between ultrasound parameters of the first visit and 9 months after except for the heel width (soft tissue variation). Odds ratio and areas under the curve (AUC) tend to increase from visit 1 to 2 for the BUA and decrease substantially for the SOS for all but the Lunar Achilles+. Nonsignificant correlation was found between the absolute difference of the ultrasound parameters measured at the two visits and the time since fracture, except for the Sahara SOS (r = 0.45; P < 0.04). In conclusion, no significant differences between QUS technologies were observed in their positive and significant ability to discriminate hip-fractured patient from controls. However, this statement is shadowed when taking into account the time since fracture which seems to negatively influence results obtained on dry versus wet QUS systems. As a result, it is advisable that such parameters would be taken into account when designing a study aimed to demonstrate the discriminatory ability of heel ultrasound between normal and hip-fractured patients. Adult Aged Aged, 80 and over Area Under Curve Bone Density/physiology Calcaneus/ultrasonography Cross-Sectional Studies Female Hip Fractures/etiology/ultrasonography Humans Middle Aged Odds Ratio Osteoporosis, Postmenopausal/complications/ultrasonography Predictive Value of Tests ROC Curve Reference Values Reproducibility of Results Time Factors Ultrasonography/instrumentation/methods Dewey 616 Dewey 617 Dewey 618.97 56 Département de médecine 221 57 Département de chirurgie 222 65 Département de réadaptation et gériatrie 22B false 74 Chirurgie orthopédique et traumatologique 98 289 Génétique des Ostéoporoses 544 331 Nutrition clinique 597 Calcified tissue international 71 6 8c7ecb84-aabf-4398-bd61-24c8629ef281 Article (Published version) Restricted art%253A10.1007%252Fs00223-002-2005-6.pdf 191451 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département de réadaptation et gériatrie

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Is time since hip fracture influencing the discrimination between fractured and nonfractured subjects as assessed at the calcaneum by three technologically different quantitative ultrasound devices?	Calcified tissue international			2002	565	1

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