Dataset Information

Is health-related quality of life associated with the risk of low-energy wrist fracture: a case-control study.

ABSTRACT:

Background

Some risk factors for low-energy wrist fracture have been identified. However, self-reported measures such as health-related quality of life (HRQOL) have not been examined as potential risk factors for wrist fracture. The aims of this study were to compare HRQOL prior to a low-energy wrist fracture in elderly patients (>or= 50 years) with HRQOL in age- and sex-matched controls, and to explore the association between HRQOL and wrist fracture after adjusting for known risk factors for fracture such as age, weight, osteoporosis and falls.

Methods

Patients with a low-energy wrist fracture (n = 181) and age- and sex-matched controls (n = 181) were studied. Shortly after fracture (median 10 days), patients assessed their HRQOL before fracture using the Short Form 36 (SF-36). Statistical tests included t tests and multivariate logistic regression analysis.

Results

Several dimensions of HRQOL were significantly associated with wrist fracture. The direction of the associations with wrist fracture varied between the different sub-dimensions of the SF-36. After controlling for demographic and clinical variables, higher scores on general health (odds ratio (OR) = 1.31, 95% confidence interval (CI) = 1.10-1.56), bodily pain (OR = 1.18, 95% CI = 1.03-1.34) and mental health (OR = 1.39, 95% CI = 1.09-1.79) were related to an increased chance of being a wrist fracture patient rather than a control. In contrast, higher scores on physical role limitation (OR = 0.87, 95% CI = 0.79-0.95) and social function (OR = 0.65, 95% CI 0.53-0.80) decreased this chance. Significant associations with wrist fracture were also found for living alone (OR = 1.91, 95% CI 1.07-3.4), low body mass index (BMI) (OR = 0.92, 95% CI 0.86-0.98), osteoporosis (OR = 3.30, 95% CI 1.67-6.50) and previous falls (OR = 2.01, 95% CI 1.16-3.49).

Conclusion

Wrist fracture patients perceive themselves to be as healthy as the controls before fracture. Our data indicate that patients with favourable and unfavourable HRQOL measures may be at increased risk of wrist fracture.

SUBMITTER: Rohde G

PROVIDER: S-EPMC2714004 | biostudies-literature | 2009 Jul

REPOSITORIES: biostudies-literature

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Publications

Is health-related quality of life associated with the risk of low-energy wrist fracture: a case-control study.

Rohde Gudrun G Mengshoel Anne M AM Wahl Astrid K AK Moum Torbjorn T Haugeberg Glenn G

BMC musculoskeletal disorders 20090703

<h4>Background</h4>Some risk factors for low-energy wrist fracture have been identified. However, self-reported measures such as health-related quality of life (HRQOL) have not been examined as potential risk factors for wrist fracture. The aims of this study were to compare HRQOL prior to a low-energy wrist fracture in elderly patients (>or= 50 years) with HRQOL in age- and sex-matched controls, and to explore the association between HRQOL and wrist fracture after adjusting for known risk facto ...[more]

PMID: 19573252

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Project description:IntroductionDue to the aging population the incidence of Low Energy Fractures (LEF) increases. LEF have high mortality and morbidity rates and often cause elderly to lose independence. Patient-reported outcomes, such as Quality of Life (QoL) and patient satisfaction (PS) are needed to evaluate treatment, estimate cost-benefit analyses, and to improve clinical decision-making and patient-centered care.ObjectiveThe primary goal was to evaluate QoL and PS in patients with LEF, and to compare QoL scores to the community dwelling population. Second, we observed the amount and type of physiotherapy (PT) sessions the patients conducted.MethodsA single-center cohort study was conducted in Switzerland. Patients between 50 and 85 years, who were treated in the hospital for LEF, were followed 1 year after initial fracture. Data on QoL were obtained through the Euroqol-5-Dimension questionnaire-3-Level (EQ-5D-3L) and the EQ VAS (visual analog scale). PS was measured by a VAS on satisfaction with treatment outcome. Data on PT sessions, mobility and use of analgesics were collected by telephone interviews and written surveys. Results were compared between the different fracture locations and subgroup analyses were performed for age categories.Results411 patients were included for analysis. The median scores of the EQ-5D-3L index-VAS and PS were 0.90 (0.75-1.0), 90 (71.3-95) and 100 (90-100). Significant differences in all scores were found between fracture location (P < .05), with hip fracture patients and patients with a malleolar fracture scoring lowest in all measures. QoL index in hip fracture patients was 0.76 (0.70-1.00), QoL VAS 80 (70-90), and PS 95 (80-100). Median amount of PT sessions in all patients was 18 (9-27) and a significant difference was found between fracture locations. Patients with a fracture of the humerus received the highest amount of PT sessions 27 (18-36), hip fracture patients had a median of 18 (9-27) sessions.ConclusionAt follow-up, QoL throughout all patients with a LEF was comparable to a normal population. Remarkably, though hip fracture patients seem to suffer from a clinically relevant loss of QoL, they received fewer PT sessions and performed fewer long-lasting home training than patients with a humerus fracture. Intensive, progressive rehabilitation with a high frequency of supervised training is recommended after hip fracture. The low frequency of PT sessions found in this study is unsatisfying. In hip fracture patients and in patients with a malleolar fracture, especially when aged over 75 years, more efforts are required to improve rehabilitation and subsequently QoL.

Dataset Information

Is health-related quality of life associated with the risk of low-energy wrist fracture: a case-control study.

Background

Methods

Results

Conclusion

Publications

Is health-related quality of life associated with the risk of low-energy wrist fracture: a case-control study.

Similar Datasets

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