J Bone Metab.  2017 Nov;24(4):217-222. 10.11005/jbm.2017.24.4.217.

Factors Affecting Bone Mineral Density Measurement after Fracture in South Korea

• Kim JW
• Ha YC
• Lee YK

• KMID: 2397554
• DOI: http://doi.org/10.11005/jbm.2017.24.4.217

Abstract

BACKGROUND
Prior osteoporotic fractures are strongly associated with the subsequent fractures. To prevent this, the diagnosis of osteoporosis following an osteoporotic fracture is important. The measurement of bone mineral density (BMD) is the first step for the diagnosis and management of osteoporosis. Therefore, the purposes of this study are 1) to evaluate the rate of BMD measurement after osteoporotic fracture in Korean population; and 2) determine the associated factors with BMD measurement after fractures among Korean patients.
METHODS
From database of Health Insurance Review & Assessment Service, we identified patients with osteoporotic fractures happened in 2010. The BMD examinations were evaluated by using procedure codes. We evaluated the rate of BMD measurement within 6 months after fracture according to gender, age group (10-year incremental), type of insurance, residency area (rural vs. urban), type of medical institute, department, history of depression, rheumatoid arthritis, medical history suggestive of secondary osteoporosis, osteoporosis-induced drug, and number of family members.
RESULTS
During study period, about a half (53.9%) of patients with osteoporotic fractures had BMD measurement. Men, younger age, urban residency, and depression history were associated with low rate of BMD measurement. However, increasing age, use of glucocorticoid use, osteoporosis-inducing comorbid disease including rheumatologic disease, and osteoporosis-induced drug user were associated with higher likelihood of BMD measurement.
CONCLUSIONS
Our results showed that about a half of patients with osteoporotic fractures had BMD measurement in South Korea, and provided the basic information to encourage management after fracture by educating not only patient but also physician about post-fracture management.

Keyword

Bone density; Osteoporotic fractures; Risk factors

MeSH Terms

Arthritis, Rheumatoid
Bone Density*
Depression
Diagnosis
Drug Users
Humans
Insurance
Insurance, Health
Internship and Residency
Korea*
Male
Osteoporosis
Osteoporotic Fractures
Risk Factors

Reference

1. Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992; 2:285–289.

2. Court-Brown CM, Clement ND, Duckworth AD, et al. The spectrum of fractures in the elderly. Bone Joint J. 2014; 96-B:366–372.

3. Hodsman AB, Leslie WD, Tsang JF, et al. 10-year probability of recurrent fractures following wrist and other osteoporotic fractures in a large clinical cohort: an analysis from the Manitoba Bone Density Program. Arch Intern Med. 2008; 168:2261–2267.

4. Kherad M, Mellstrom D, Rosengren BE, et al. The number and characteristics of prevalent vertebral fractures in elderly men are associated with low bone mass and osteoporosis. Bone Joint J. 2015; 97-B:1106–1110.

5. Choi WS, Lee HJ, Kim DY, et al. Does osteoporosis have a negative effect on the functional outcome of an osteoporotic distal radial fracture treated with a volar locking plate? Bone Joint J. 2015; 97:229–234.

6. Ha YC, Park YG, Nam KW, et al. Trend in hip fracture incidence and mortality in Korea: a prospective cohort study from 2002 to 2011. J Korean Med Sci. 2015; 30:483–488.

7. Park C, Ha YC, Jang S, et al. The incidence and residual lifetime risk of osteoporosis-related fractures in Korea. J Bone Miner Metab. 2011; 29:744–751.

8. Klop C, Gibson-Smith D, Elders PJ, et al. Anti-osteoporosis drug prescribing after hip fracture in the UK: 2000-2010. Osteoporos Int. 2015; 26:1919–1928.

9. von Friesendorff M, Besjakov J, Åkesson K. Long-term survival and fracture risk after hip fracture: a 22-year followup in women. J Bone Miner Res. 2008; 23:1832–1841.

10. Warriner AH, Patkar NM, Yun H, et al. Minor, major, low-trauma, and high-trauma fractures: what are the subsequent fracture risks and how do they vary? Curr Osteoporos Rep. 2011; 9:122–128.

11. Lee JH, Lee YH, Moon SH, et al. Influence of insurance benefit criteria on the administration rate of osteoporosis drugs in postmenopausal females. Clin Orthop Surg. 2014; 6:56–61.

12. Elliot-Gibson V, Bogoch ER, Jamal SA, et al. Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int. 2004; 15:767–778.

13. Leslie WD, Giangregorio LM, Yogendran M, et al. A population-based analysis of the post-fracture care gap 1996-2008: the situation is not improving. Osteoporos Int. 2012; 23:1623–1629.

14. Panneman MJ, Lips P, Sen SS, et al. Undertreatment with anti-osteoporotic drugs after hospitalization for fracture. Osteoporos Int. 2004; 15:120–124.

15. Shepherd AJ, Cass AR, Ray LA, et al. Treatment for older men with fractures. Osteoporos Int. 2012; 23:1041–1051.

16. Lee YK, Yoon BH, Koo KH. Epidemiology of osteoporosis and osteoporotic fractures in South Korea. Endocrinol Metab (Seoul). 2013; 28:90–93.

17. Kim TI, Choi JH, Kim SH, et al. The adequacy of diagnosis and treatment for osteoporosis in patients with proximal humeral fractures. Clin Orthop Surg. 2016; 8:274–279.

18. Mettyas T, Carpenter C. Secondary prevention of osteoporosis in non-neck of femur fragility fractures: is it value for money? A retrospective, prospective and cross-sectional cohort study. J Orthop Surg Res. 2013; 8:44.

19. Yoon HK, Lee YK, Ha YC. Characteristics of patients diagnosed with osteoporosis in South Korea: results from the national claim registry. J Bone Metab. 2017; 24:59–63.

20. Park C, Jang S, Lee A, et al. Incidence and mortality after proximal humerus fractures over 50 years of age in South Korea: national claim data from 2008 to 2012. J Bone Metab. 2015; 22:17–21.

21. Yoon HK, Park C, Jang S, et al. Incidence and mortality following hip fracture in Korea. J Korean Med Sci. 2011; 26:1087–1092.

22. Watts NB, Geusens P, Barton IP, et al. Relationship between changes in BMD and nonvertebral fracture incidence associated with risedronate: reduction in risk of nonvertebral fracture is not related to change in BMD. J Bone Miner Res. 2005; 20:2097–2104.

23. Yoo JH, Moon SH, Ha YC, et al. Osteoporotic fracture: 2015 position statement of the Korean society for bone and mineral research. J Bone Metab. 2015; 22:175–181.

24. Lau E, Ong K, Kurtz S, et al. Mortality following the diagnosis of a vertebral compression fracture in the medicare population. J Bone Joint Surg Am. 2008; 90:1479–1486.

25. Kang HY, Yang KH, Kim YN, et al. Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the national health insurance claims data. BMC Public Health. 2010; 10:230.

26. Cadarette SM, Katz JN, Brookhart MA, et al. Trends in drug prescribing for osteoporosis after hip fracture, 1995-2004. J Rheumatol. 2008; 35:319–326.

27. Roerholt C, Eiken P, Abrahamsen B. Initiation of anti-osteoporotic therapy in patients with recent fractures: a nationwide analysis of prescription rates and persistence. Osteoporos Int. 2009; 20:299–307.

28. Bessette L, Jean S, Davison KS, et al. Factors influencing the treatment of osteoporosis following fragility fracture. Osteoporos Int. 2009; 20:1911–1919.