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

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.