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Konstantinou P, Kostretzis L, Fragkiadakis G, Touchtidou P, Mavrovouniotis A, Davitis V, Ditsiou AZ, Gigis I, Nikolaides AP, Niakas D, Papadopoulos P, Ditsios K. Exploring Quality of Life and Mortality in Pertrochanteric Fragility Hip Fractures in Northern Greece: A Single Tertiary Center Study. J Clin Med 2024; 13:2478. [PMID: 38731006 PMCID: PMC11084555 DOI: 10.3390/jcm13092478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Fragility-related pertrochanteric fractures have become a significant public health concern, with a rising incidence attributed to the expanding elderly demographic. Assessing patient-reported health-related quality of life (HRQoL), mortality, and factors correlated with them serves as a crucial metric in evaluating the effectiveness of hip fracture surgery. Methods: In a single-center retrospective study, 259 patients underwent surgical treatment with a cephalomedullary nail, with a mean follow-up of 21.7 months. Health-related quality of life (HRQoL) was assessed using SF-12 (12-item Short Form) and EQ-5D (EuroQoL-5 Dimensions) questionnaires. Mobility status was measured by the Crude Mobility Index (CMI). Surveys were administered during hospitalization and six months postoperatively. Statistical analysis involved descriptive statistics, non-parametric controls (Kendall, Mann-Whitney, and Wilcoxon), and Spearman correlation and logistic regression analysis, which were conducted using IBM SPSS version 28. Results: A statistically significant decrease was observed in the mean EQ-5D and SF-12 scores at 6 months post-op compared to the pre-fracture status. The ASA (American Society of Anaesthesiologists) score showed a significant correlation with the decrease in HRQoL measured by the SF-12 questionnaire. The 30-day post-operative mortality rate was 9.3%, increasing to 32.4% at 1 year. Notably, the 30-day mortality significantly rose during the pandemic era (5.0% vs. 12.0%; p = 0.003). Conclusions: Pertrochanteric hip fractures cause a lasting decline in quality of life. Annual mortality is high, and further investigations are needed to formulate policies that prevent hip fractures and reduce mortality rates.
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Affiliation(s)
- Panagiotis Konstantinou
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B7 5TE, UK;
| | - Lazaros Kostretzis
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
| | - Georgios Fragkiadakis
- Healthcare Management, School of Social Science, Hellenic Open University, 263 35 Patra, Greece; (G.F.); (D.N.)
| | - Panagiota Touchtidou
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
| | - Argyrios Mavrovouniotis
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
| | - Vasileios Davitis
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
| | - Athina Zacharoula Ditsiou
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Ioannis Gigis
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
| | | | - Dimitris Niakas
- Healthcare Management, School of Social Science, Hellenic Open University, 263 35 Patra, Greece; (G.F.); (D.N.)
| | - Pericles Papadopoulos
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
| | - Konstantinos Ditsios
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, “G. Gennimatas” Hospital, Eth. Aminis 41, 546 35 Thessaloniki, Greece; (L.K.); (P.T.); (A.M.); (V.D.); (I.G.); (P.P.); (K.D.)
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Soukkio PK, Suikkanen SA, Sintonen H, Kukkonen-Harjula KT, Kautiainen H, Kääriä SM, Hupli MT, Aartolahti EM, Pitkälä KH, Sipilä S. Health-related quality of life after hip fracture: effects of a 12-month home-based exercise intervention-secondary analyses of an RCT. Qual Life Res 2024; 33:541-550. [PMID: 37932555 DOI: 10.1007/s11136-023-03545-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE In this randomized controlled trial, we analyzed the effects of a 12-month home-based exercise intervention on the health-related quality of life (HRQoL) of patients with a hip fracture. METHODS Participants (n = 121) aged ≥ 60 years, with a Mini-Mental State Examination (MMSE) score of ≥ 12 and an operated hip fracture, were placed into Exercise (n = 61) or Usual care (n = 60) groups. Physiotherapist-supervised, home-based training was given twice a week over 12 months. HRQoL was assessed using the 15D instrument at baseline and at 3, 6, and 12 months. The total 15D scores and dimension scores were analyzed and compared to national age- and sex-matched reference data. RESULTS The participants' mean age was 81 years (SD 7), 75% were women, and 61% had a femoral neck fracture. The mean within-group change in total 15D score over 12 months was 0.023 (95% CI: -0.003 to 0.048) in the Usual care group, and 0.028 (CI: 0.003 to 0.054) in the Exercise group (between-group p = 0.76). We found a statistically significant change in total 15D score in the Exercise group, as well as in the dimension scores of mobility and usual activities in both groups. All 15D scores remained below the general population reference level. CONCLUSION Exercise training for 12 months did not enhance the HRQoL of home-dwelling patients with hip fractures any more than usual care. In addition, HRQoL remained below the population level in both groups.
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Affiliation(s)
- Paula K Soukkio
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland.
- Development Services, Wellbeing Services County of South Karelia, Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland.
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, 40700, Jyväskylä, Finland.
| | - Sara A Suikkanen
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland
- Faculty of Health Care and Social Services, LAB University of Applied Sciences, Yliopistonkatu 36, 53850, Lappeenranta, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
| | - Katriina T Kukkonen-Harjula
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, PO BOX 100, 70029 KYS, Kuopio, Finland
- Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland
| | - Sanna M Kääriä
- Raatimiehet Oy, Raatimiehenkatu 18, 53100, Lappeenranta, Finland
| | - Markku T Hupli
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland
| | - Eeva M Aartolahti
- Institute of Rehabilitation, JAMK University of Applied Sciences, Piippukatu 2, 40100, Jyväskylä, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Tukholmankatu 8 B, 00290, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Tukholmankatu 8 B, 00290, Helsinki, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, 40700, Jyväskylä, Finland
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Unnanuntana A, Kuptniratsaikul V, Srinonprasert V, Charatcharoenwitthaya N, Kulachote N, Papinwitchakul L, Wattanachanya L, Chotanaphuti T. A multidisciplinary approach to post-operative fragility hip fracture care in Thailand - a narrative review. Injury 2023; 54:111039. [PMID: 37757673 DOI: 10.1016/j.injury.2023.111039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Appropriate care and rehabilitation following surgery for fragility hip fractures in older adults is associated with better outcomes and a greater likelihood of achieving pre-injury functioning. Clinical guidelines specifically for the post-operative care and rehabilitation of patients with hip fractures are scarce; as such, country-specific protocols benchmarked against established guidelines are essential given the wide variation in cultures and beliefs, clinical practice and diverse healthcare systems in Asia. We aimed to provide clinically relevant recommendations for post-operative fragility hip fracture care and rehabilitation to improve patient outcomes and prevent subsequent fractures in Thailand. METHODS A targeted literature review was conducted to identify key evidence on various elements of post-hip fracture care and rehabilitation. Further discussions at a meeting and over email correspondence led to the development of the recommendations which amalgamate available evidence with the clinical experience of the multidisciplinary expert panel. RESULTS Our recommendations are categorized by one period domain - acute post-operative period, and five major domains during the post-operative period - rehabilitation, optimization of bone health, prevention of falls, nutritional supplementation, and prophylaxis for venous thromboembolism. A multidisciplinary approach should be central to the rehabilitation process with the involvement of orthopedists, geriatricians/internists, physiatrists, physical and occupational therapists, endocrinologists, pharmacists and nursing staff. Other key components of our recommendations which we believe contribute to better functional outcomes in older patients undergoing hip fracture surgery include comprehensive pre-operative assessments, early surgery, goal setting for recovery and rehabilitation, early mobilization, medication optimization, tailored exercise plans, adequate coverage with analgesia, assessment and appropriate management of osteoporosis with due consideration of the fracture risk, fall prevention plans, and nutritional assessment and support. Patients and their caregivers should be a part of the recovery process at every step, and they should be counseled and educated appropriately, particularly on the importance of adherence to their rehabilitation plan. CONCLUSION We have provided guidance on the critical domains of clinical care in the post-operative setting to optimize patient outcomes and prevent fracture recurrence. Our recommendations for post-operative care and rehabilitation of older adults with hip fracture can serve as a framework for hospitals across Thailand.
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Affiliation(s)
- Aasis Unnanuntana
- Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand.
| | - Vilai Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Varalak Srinonprasert
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Natthinee Charatcharoenwitthaya
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Noratep Kulachote
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Lalita Wattanachanya
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Excellence Center for Diabetes, Hormone and Metabolism, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Thanainit Chotanaphuti
- Department of Orthopedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
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Jayasekera PT, Fernandopulle R, Weerasenghe T, de Soysa S, Ranaweera T, Edirisinghe E. Hip fractures and outcome in elderly patients in a tertiary care hospital of Sri Lanka. Arch Osteoporos 2023; 18:113. [PMID: 37672198 DOI: 10.1007/s11657-023-01323-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
Abstract
This study assessed how elderly patients with hip fractures were affected by factors such as comorbidities, fracture type, treatments, complications, and health-related quality of life. The majority of participants had surgery for their fracture with good prognoses despite having comorbidities. Reductions in the general level of activities related to daily living were proportionately higher even after one year. INTRODUCTION Hip fractures in older adults are associated with significant morbidity, mortality, loss of independence, and financial burdens. In this study, we assessed how these effects were influenced by factors such as comorbidities, fracture type, treatment methods, complications, and health-related quality of life (HRQoL) in elderly patients presented with hip fractures. METHODS A prospective observational study was conducted over 6 months on all patients with fall and hip fractures above 65 years of age that presented to the Accident and Emergency Department (A&E) of Provincial General Hospital Kurunegala. The subjects were followed up with for up to 1 year. Data forms were made according to the Charlson comorbidity index, the Johns Hopkins Fall Risk Assessment tool, and the International Society of Fracture Repair-International Osteoporosis Foundation (ISFR-IOF)) hip fracture outcome working group recommendations. Direct questions from these assessment guides were not used in data collection. Being able to walk independently and return to a premorbid state following surgery was considered a good outcome. RESULTS There were 117 patients (mean age 78 (± 7.31) years); 80% were female. Out of them, 81% had comorbidities without significant morbidity or mortality during surgery. Ninety-six (88%) had surgery for their fracture with good prognoses (p<0.05) and better outcomes due to early surgery (p=0.008). Independent walking was significantly better in intracapsular fractures than extracapsular fractures (p<0.05). Patients with post-surgical complications had significant mortality (p<0.001). Ninety-nine per cent, 81%, and 75% of patients remained dependent 1 month, 3 months, and 1 year following surgery, respectively. HRQoL was impaired in 3 months (95% SF, 12<50) and in 1 year (78.6% SF, 12 <50) following surgery. The mortality during admission, in 1 month, 3 months, and 1 year was 8.5% (10), 14.5% (17), 21.3% (25), and 35% (41), respectively. CONCLUSION A greater majority of hip fracture victims were female. Prognoses were good after surgery irrespective of the comorbidities with better outcomes in early surgery. Independent walking was significantly better in intracapsular fractures than extracapsular fractures. Patients with post-surgical complications had significant mortality. Significant loss of HRQoL increased in patients even after surgery, which resulted in an increased burden to families.
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Affiliation(s)
| | | | - T Weerasenghe
- Provincial General Hospital Kurunegala, Kurunegala, Sri Lanka
| | - S de Soysa
- Provincial General Hospital Kurunegala, Kurunegala, Sri Lanka
| | - T Ranaweera
- Provincial General Hospital Kurunegala, Kurunegala, Sri Lanka
| | - Emdt Edirisinghe
- University Hospital Kotelawala Defence University, Boralesgamuwa, Sri Lanka
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Merchán-Galvis AM, Muñoz-García DA, Solano F, Velásquez JC, Sotelo NF, Molina DA, Caicedo JP, Concha JM, Calvache JA, Martínez-Zapata MJ. Delayed surgery and health related quality of life in patients with proximal femoral fracture. Sci Rep 2023; 13:11131. [PMID: 37429947 DOI: 10.1038/s41598-023-33592-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/15/2023] [Indexed: 07/12/2023] Open
Abstract
This study aimed to establish factors associated with delayed surgery in patients with proximal femoral fracture and to assess patients' health-related quality of life (HRQoL) after surgery including all-cause 6-months mortality. This was a single-center, observational, prospective cohort study that included patients with a proximal femur fracture. We described patients' HRQoL measured by EuroQoL (EQ-5D-5L and EQ-VAS) questionnaire and perioperative complications (including mortality) 6 months after surgery. We included 163 patients with a mean age of 80.5 years, the majority were women and 76.1% reported falling from their own height. The mean time between hospital admission and surgery was 8.3 days (SD 4.9 days) and the mean hospital stay was 13.5 days (SD 10.4 days). After adjustment, the principal factor associated with delayed surgery was adjournment in surgery authorization (3.7 days). EQ-5D-5L index values and the VAS score at 1 month after surgery were 0.489 and 61.1, at 3 months were 0.613 and 65.8, and at 6 months 0.662 and 66.7 respectively. Mortality at 6 months of follow-up was 11% (18 patients). In conclusion, administrative authorization was the strongest associated factor with delayed time from hospital admission to surgery. HRQoL of patients with a proximal femoral fracture improved 6 months after surgery.Trial registration: NCT04217642.
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Affiliation(s)
- Angela María Merchán-Galvis
- Iberoamerican Cochrane Centre-Public Health and Clinical Epidemiology, IIBSant Pau, Barcelona, Spain.
- Department of Social Medicine and Family Health, Universidad del Cauca, Popayán, Colombia.
| | | | - Felipe Solano
- Department of Anaesthesiology, Universidad del Cauca, Popayán, Colombia
| | | | | | | | | | - Juan Manuel Concha
- Department of Surgical Sciences, Universidad del Cauca, Popayán, Colombia
| | - José Andrés Calvache
- Department of Anaesthesiology, Universidad del Cauca, Popayán, Colombia
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - María José Martínez-Zapata
- Iberoamerican Cochrane Centre-Public Health and Clinical Epidemiology, IIBSant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER of Epidemiology and Public Health), Madrid, Spain
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Clinical Score for Predicting the Risk of Poor Ambulation at Discharge in Fragility Femoral Neck Fracture Patients: A Development Study. J Clin Med 2022; 11:jcm11164871. [PMID: 36013106 PMCID: PMC9410020 DOI: 10.3390/jcm11164871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Surgical treatment in patients with fragility femoral neck fractures often leads to a longer length of hospital stay (LOS) and higher costs. Intensive rehabilitation is one of the choices to reduce LOS, but patient selection criteria are controversial. We intended to develop a clinical score to predict the risk of poor ambulation at discharge. This study was based on a retrospective cohort of patients diagnosed with fragility femoral neck fractures surgically managed from January 2010 to December 2019 at Chiang Mai University (CMU) Hospital. Pre-, intra-, and post-operative factors that affect rehabilitation training were candidate predictors. All patients were categorized into able or unable groups based on their ability to bear self-weight at discharge. Logistic regression was used for score derivation. Five hundred and nine patients were included in this study. Male sex, end-stage kidney disease (ESRD), cerebrovascular disease, psychiatric disorders, pre-fracture ambulation with gait aids, concomitant fracture, post-operative intensive care unit (ICU) admission or ventilator use, and urinary catheter use at second day post-operation were identified as the prognostic factors. The score showed an AuROC of 0.84 with good calibration. The score can be used for risk stratification on the second day post-operation. External validation is encouraged before clinical implementation.
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Prognostic Factors of the Inability to Bear Self-Weight at Discharge in Patients with Fragility Femoral Neck Fracture: A 5-Year Retrospective Cohort Study in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073992. [PMID: 35409675 PMCID: PMC8997639 DOI: 10.3390/ijerph19073992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/08/2022] [Accepted: 03/25/2022] [Indexed: 12/14/2022]
Abstract
An inability to bear self-weight is one of the unfavorable results in geriatric hip fracture, which needs to be prevented. This study determines pre-operative, intra-operative, and post-operative prognostic factors of the inability to bear self-weight at discharge in patients with fragility femoral neck fracture. This retrospective study was conducted at Chiang Mai University (CMU) hospital with an observational cohort design. Electronic medical records of patients aged ≥ 50 years old with fragility femoral neck fractures between 1 January 2015 and 31 December 2019 were reviewed. Pre-, intra-, and post-operative factors were collected. Ambulation status at discharge time was classified into either ability or inability to bear self-weight. Analysis of prognostic factors was done using multivariable risk ratio regression. In total, 269 patients were recruited in this study. Significantly prognostic factors of inability to bear self-weight at discharge were end-stage renal disease (ESRD), cirrhosis, cerebrovascular disease, pre-fracture ambulatory status, having associated fractures, increasing intra-operative blood loss, and having pressure sore. These prognostic factors could be used to predict patients’ outcomes at discharge. Proper management could then be offered to the patients by the multidisciplinary care team to enhance surgical outcomes.
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Amarilla-Donoso FJ, Roncero-Martin R, Lavado-Garcia JM, Toribio-Felipe R, Moran-Garcia JM, Lopez-Espuela F. Quality of life after hip fracture: a 12-month prospective study. PeerJ 2020; 8:e9215. [PMID: 32587793 PMCID: PMC7304420 DOI: 10.7717/peerj.9215] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hip fracture is an important and frequent health problem worldwide. To date, there are still limited studies focused on the analysis of health-related quality of life (HRQOL) after a hip fracture in the Spanish population, especially with long-term follow-up. OBJECTIVE To determine the HRQOL at 12 months after hip fracture and to identify potential factors associated with HRQOL. DESIGN Prospective observational study. SETTING Traumatology units of two university hospitals in province Cáceres (Spain). PARTICIPANTS A total of 224 patients were admitted to the unit and required immediate surgery due to a hip fracture. METHODS HRQOL was measured with the EuroQol-5D questionnaire (EQ-5D) and the SF-12 Health Survey. RESULTS Scores from the visual analog scale EQ-5D decreased significantly (p < 0.001) from 72.8 at baseline to 48.3 after 1 month, to 48.2 after 6 months and to 46.1 after 12 months. The EQ-5D index score showed a similar significant reduction (p < 0.001) from 0.6 to 0.1, 0.3 and 0.3, respectively. Values of the physical component summary (PCS-12) significantly decreased (p < 0.001) from 38.6 at baseline to 31.0, 33.1 and 33.5. The mental component summary (MCS-12) decreased from 46.5 to 44.8 after 6 months (p = 0.022) and 44.3 after 12 months (p = 0.005). Factors potentially associated with HRQOL at 12 months after hip fracture were depression status after 12 months (B = 0-1.876; 95% CI [-2.409 to -1.343]; p < 0.001), functional ambulation classification after 12 months (B = -12.133; 95% CI [-17.970 to -6.297]; p < 0.001), EQ-5D VAS at baseline (B = 0.223; 95% CI [0.115-0.330]; p < 0.001), and age (B = -0.323; 95% CI [-0.594 to -0.053; p = 0.015). CONCLUSIONS Patients experience a significant impairment in HRQOL H after a hip fracture, especially in self-care, pain/discomfort, usual activities, mobility and anxiety/depression. The decline in the HRQOL is effective the first month and lasts at least 12 months after the surgical intervention.
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Affiliation(s)
| | - Raul Roncero-Martin
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Jesus Maria Lavado-Garcia
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | | | - Jose Maria Moran-Garcia
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Fidel Lopez-Espuela
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
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