Risk factors affecting hip fracture patterns in an elderly Korean patient population

Abstract

Hip fracture in the elderly patient population, particularly the Korean patient cohort, is one of the most serious complications of osteoporosis and currently increasing alongside age. In this study, we attempted to identify various factors that could either indicate the risk for an intertrochanteric or femoral neck fracture in an osteoporotic Korean hip fracture patient cohort ≥ 65 years old. A retrospective analysis of 168 patients was performed for those who underwent surgical treatment for either an intertrochanteric or femoral neck fracture at Daegu Catholic University Medical Center from January 2013 to December 2015. Inclusion criteria included patients who sustained a intertrochanteric or femoral neck fracture between the designated time frame, ≥65 years old, and of Korean ethnicity. Differences between the T-score and Z-score regarding bone mineral density (BMD) and the relationship between BMD and subtype of the fracture for the intertrochanteric (n = 92) and femoral neck fracture (n = 76) groups were obtained. Demographical factors (age, sex, weight, height, and body mass index [BMI]) were analyzed as potential risk factors for intertrochanteric or femoral neck fractures using software. Of the total 168 patients, mean weight and BMI values were found to be lower in the intertrochanteric fracture group (P = .033) compared to the femoral neck fracture group (P = .044). Additionally, Z-scores for the intertrochanteric fracture group were lower in the trochanter (P = .030), intertrochanteric (P = .029), and Ward’s triangle (P = .029) regions. Regarding the intertrochanteric fracture group, the A3 subgroup showed lower T-scores of the trochanteric region than the A1 fracture subgroup (P = .010). In an elderly Korean hip patient cohort, lower body weight, BMI, and BMD Z-scores are correlated with a higher incidence of intertrochanteric fractures when compared to femoral neck hip fractures.