Session Information
Date: Sunday, November 13, 2016
Title: Osteoporosis and Metabolic Bone Disease – Clinical Aspects and Pathogenesis - Poster
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: The high rates of readmission among patients with osteoporotic vertebral fracture have reduced quality of life and increased mortality. This study aimed to determine predictors of readmission in such patients using magnetic resonance imaging (MRI).
Methods: This study reviewed records of osteoporosis patients with acute vertebral fractures proven by MRI between 2004 and 2007 for pre-operative MRI, subsequent readmission, and possible factors that increase readmission within two years. Clinical information like co-morbidities, previous hip fracture, and number of vertebral fractures were recorded. Primary outcome was readmission (within two years of discharge). Predictor variables were categorized and compared between readmissions and non-readmissions. Logistic regression was used for multivariate analysis.
Results: There were 106 patients with MRI-proven acute vertebral fractures who underwent vertebroplasty, including 33 with readmission within two years. There were no differences in age, BMI, sex, number of vertebral fracture, and underlying co-morbidities between readmissions and non-readmissions. However, the MRI signal intensity (SI) at the non-enhancement area parameter was different between the two groups (70.97±66.51 vs. 108.62±98.31; p=0.008). After adjusting for potential confounders, those with higher SI at the non-enhancement area had lower readmission risk (p=0.005; OR: 0.984, 95% CI: 0.973-0.995).
Conclusion: Pre-operative MRI may be predictive of readmission in patients with osteoporotic vertebral fracture. Recognizing the need to optimize primary and secondary prevention in these patients to improve quality of life is mandatory.
| Table . Multivariable analysis of the odds ratios for readmission | ||||||||
| Variables |
Regression coefficient |
S.E. |
Wals |
p value |
OR (95% CI) |
|||
| Age (years) |
-0.054 |
0.032 |
2.812 |
0.094 |
0.947 (0.890-1.009) | |||
| Sex |
0.602 |
0.629 |
0.914 |
0.339 |
1.825 (0.532-6.268) | |||
| Body mass index (kg/m2) |
-0.056 |
0.042 |
1.778 |
0.182 |
0.945 (0.871-1.027) | |||
| Spine fracture (number) |
-0.029 |
0.142 |
0.040 |
0.841 |
0.971 (0.736-4.284) | |||
| Previous hip fracture |
0.692 |
0.644 |
1.152 |
0.283 |
1.997 (0.565-7.063) | |||
| Rheumatoid arthritis |
-0.814 |
0.996 |
0.668 |
0.414 |
0.442 (0.063-3.121) | |||
| Diabetes mellitus |
-0.781 |
0.445 |
3.081 |
0.079 |
0.457 (0.191-1.095) | |||
| Hypertension |
-0.059 |
0.382 |
0.024 |
0.878 |
0.943 (0.446-1.994) | |||
| Heart disease |
-0.382 |
1.135 |
0.113 |
0.736 |
0.682 (0.074-6.311) | |||
| Pulmonary disease |
-0.263 |
1.045 |
0.063 |
0.802 |
0.769 (0.099-5.965) | |||
| Liver disease |
-1.045 |
0.920 |
1.289 |
0.256 |
0.351 (0.058-2.136) | |||
| Glucorcorticoid use |
0.498 |
0.630 |
.625 |
0.429 |
1.645 (0.479-5.653) | |||
| Enhancement SI |
0.005 |
0.003 |
3.645 |
0.056 |
1.004 (1.000-1.010) | |||
| Non-enhancement SI |
-0.016 |
0.006 |
7.929 |
0.005 |
0.984 (0.973-0.995) |
|||
| Abbreviations: OR, odds ratio; SE, standard error; SI, signal intensity | ||||||||
To cite this abstract in AMA style:
Chen YC Sr.. Pre-Operative Magnetic Resonance Imaging Can Help in Predicting Two-Year Readmission in Acute Severe Osteoporotic Vertebral Fracture after Vertebroplasty [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/pre-operative-magnetic-resonance-imaging-can-help-in-predicting-two-year-readmission-in-acute-severe-osteoporotic-vertebral-fracture-after-vertebroplasty/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/pre-operative-magnetic-resonance-imaging-can-help-in-predicting-two-year-readmission-in-acute-severe-osteoporotic-vertebral-fracture-after-vertebroplasty/