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Observational Study
. 2018 Mar;29(3):557-566.
doi: 10.1007/s00198-017-4317-4. Epub 2017 Dec 11.

Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures-results from the ICUROS

A Svedbom  1 , F Borgstöm  2 , E Hernlund  3 , O Ström  2 , V Alekna  4 , M L Bianchi  5 , P Clark  6 , M D Curiel  7   8 , H P Dimai  9 , M Jürisson  10 , R Kallikorm  10 , M Lember  10 , O Lesnyak  11   12 , E McCloskey  13 , K M Sanders  14 , S Silverman  15 , A Solodovnikov  11 , M Tamulaitiene  4 , T Thomas  16 , N Toroptsova  17 , A Uusküla  10 , A N A Tosteson  18 , B Jönsson  19 , J A Kanis  14   20
Affiliations
Observational Study

Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures-results from the ICUROS

A Svedbom et al. Osteoporos Int. 2018 Mar.

Abstract

This study used data from the International Costs and Utilities Related to Osteoporotic fractures Study (ICUROS) to estimate the quality of life (QoL) impact of fracture. Hip, vertebral, and distal forearm fractures incur substantial QoL losses. Hip and vertebral fracture results in markedly impaired QoL for at least 18 months.

Introduction: The International Costs and Utilities Related to Osteoporotic fractures Study (ICUROS) is a multinational observational study that aims to describe costs and quality of life (QoL) consequences of osteoporotic fractures. To date, 11 countries have participated in the study: Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, the UK, and the USA. The objective of this paper is to describe the QoL impact of hip, vertebral, and distal forearm fracture.

Methods: Data were collected at four time-points for five QoL point estimates: within 2 weeks after fracture (including pre-fracture recall) and at 4, 12, and 18 months after fracture. Quality of life was measured as health state utility values (HSUVs) derived from the EQ-5D-3L. Complete case analysis was conducted as the base case with available case and multiple imputation performed as sensitivity analyses. Multivariate analysis was performed to explore predictors of QoL impact of fracture.

Results: Among 5456 patients enrolled using convenience sampling, 3021 patients were eligible for the base case analysis (1415 hip, 1047 distal forearm, and 559 vertebral fractures). The mean (SD) difference between HSUV before and after fracture for hip, vertebral, and distal forearm fracture was estimated at 0.89 (0.40), 0.67 (0.45), and 0.48 (0.34), respectively (p < 0.001 for all fracture types). Eighteen months after fracture, mean HSUVs were lower than before the fracture in patients with hip fracture (0.66 vs. 0.77 p < 0.001) and vertebral fracture (0.70 vs. 0.83 p < 0.001). Hospitalization and higher recalled pre-fracture QoL were associated with increased QoL impact for all fracture types.

Conclusions: Hip, vertebral, and distal forearm fractures incur substantial loss in QoL and for patients with hip or vertebral fracture, QoL is markedly impaired for at least 18 months.

Keywords: EQ-5D; Fracture; Health-related quality of life; Osteoporosis.

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