Hip Pelvis.  2018 Dec;30(4):233-240. 10.5371/hp.2018.30.4.233.

Does Simultaneous Computed Tomography and Quantitative Computed Tomography Show Better Prescription Rate than Dual-energy X-ray Absorptiometry for Osteoporotic Hip Fracture?

• Ko JH
• Lim S
• Lee YH
• Yang IH
• Kam JH
• Park KK

• KMID: 2427927
• DOI: http://doi.org/10.5371/hp.2018.30.4.233

Abstract

PURPOSE
This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA).
MATERIALS AND METHODS
This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit.
RESULTS
The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P < 0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P < 0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively.
CONCLUSION
Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.

Keyword

Osteoporosis; Hip fractures; Quantitative computed tomography; Photon absorptiometry

MeSH Terms

Absorptiometry, Photon*
Ambulatory Care Facilities
Arthroplasty
Hip Fractures
Hip*
Humans
Medication Adherence
Osteoporosis
Prescriptions*

Figure

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  Fig. 1 Flowchart of this study.Fx: fracture, QCT: quantitative computed tomography, DXA: dual-energy X-ray absorptiometry, BMD: bone mineral density, PO: postoperative.

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  Fig. 2 Cumulative bone mineral density (QCT) evaluation rate (%) according to time point and group (QCT vs. DXA). All of the patients in the QCT group were evaluated for osteoporosis because simultaneous CT and QCT were performed at the first visit to emergency department.QCT: quantitative computed tomography, DXA: dual-energy X-ray absorptiometry, PO: postoperative.

• 

  Fig. 3 Cumulative prescription rate (%) according to time and group (QCT vs. DXA).* Significant difference in the rate of new osteoporosis medication prescriptions at individual time points between the two groups. A significant difference in prescription rate was found at discharge (P<0.001), whereas no difference was found thereafter.†Significant difference in cumulative prescription rate of osteoporosis medication at postoperative (PO) week 12 was observed between the two groups.QCT: quantitative computed tomography, DXA: dual-energy X-ray absorptiometry, BMD: bone mineral density.

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