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Loss of health related quality of life following low-trauma fractures in the elderly.

Tarride JE, Burke N, Leslie WD, Morin SN, Adachi JD, Papaioannou A, Bessette L, Brown JP, Pericleous L, Muratov S, Hopkins RB - BMC Geriatr (2016)

Bottom Line: The HUI-2, a validated HRQoL instrument, allows the calculation of health utility where 0 represents death and 1 the best imaginable health state.Of the 6 HUI-2 domains, mobility had the largest impact on change in HRQoL.Regression analysis indicated that living with a musculoskeletal disorder or a neurological condition and living in LTC were associated with greater decrements in utility following a fracture.

View Article: PubMed Central - PubMed

Affiliation: Programs for Assessment of Technology in Health (PATH), St. Joseph's Healthcare Hamilton, 25 Main Street West, Suite 2000, Hamilton, ON, L8P 1H1, Canada. tarride@mcmaster.ca.

ABSTRACT

Background: To estimate the long-term change in health related quality of life (HRQoL) following low-trauma fractures among individuals receiving home care (HC) services or living in long-term care (LTC) facilities using linked healthcare administrative data from Ontario, Canada.

Methods: HRQoL was estimated using the Health Utility Index (HUI-2) with the InterRai Minimum Data Set (MDS), a mandatory questionnaire for LTC and HC in the province of Ontario (population 14 million). The HUI-2, a validated HRQoL instrument, allows the calculation of health utility where 0 represents death and 1 the best imaginable health state. For reference, the HUI-2 utility value for Canadians aged 80-84 years is 0.61 and the minimal clinically important difference is 0.03. The MDS was linked to Ontario acute care databases for fiscal years 2007-2011 to identify low-trauma fractures using ICD-10-CA codes. Regression models were used to identify predictors of change in HRQoL from pre-fracture levels to 3 years post fracture for several populations. Low-trauma fractures included hip, humerus, vertebral, wrist, multiple and other.

Results: Twenty-three thousand six-hundred fifty-five unique patients with low-trauma fractures were identified with pre- and post-fracture HRQoL assessments, of which 5057 individuals had at least 3 years of follow-up. Compared to patients receiving HC services (N = 3303), individuals residing in LTC (N = 1754) were older, taking more medications, and had more comorbidities. LTC patients had more hip fractures (49 % of total versus 29 %). For all fracture types, HRQoL decreased immediately following fracture. Although levels rebounded after the first month, HRQoL up to 36 months never returned to pre-fracture levels even for non-hip fracture. For both HC and LTC cohorts, clinically important and statistically significant decreases in HUI-2 utility scores were observed 36 months post fracture. Of the 6 HUI-2 domains, mobility had the largest impact on change in HRQoL. Regression analysis indicated that living with a musculoskeletal disorder or a neurological condition and living in LTC were associated with greater decrements in utility following a fracture.

Conclusions: Based on the analysis of one of the largest studies on HRQoL to date, among individuals living in LTC facilities or receiving HC services, fractures have a significant permanent impact on HRQoL up to 3 years following fracture.

No MeSH data available.


Related in: MedlinePlus

Health Related Quality of Life (HRQoL) Pre- and Post-Fracture, Hip Fracture, by duration of follow-up censored by death (Home Care and Long-term Care cohorts combined)
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Fig4: Health Related Quality of Life (HRQoL) Pre- and Post-Fracture, Hip Fracture, by duration of follow-up censored by death (Home Care and Long-term Care cohorts combined)

Mentions: Our analyses excluded 967 individuals who died within 36 months following a fracture. For those individuals dying within 36 months after a fracture, the decrement in HRQoL post fracture was overall similar to patients who did not die (Fig. 4). In general, there was a clinically important decrease in HRQoL in the period prior to death for all patients independent of the time of death in the range of 0.33 to 0.37 for all lengths of follow-up.Fig. 4


Loss of health related quality of life following low-trauma fractures in the elderly.

Tarride JE, Burke N, Leslie WD, Morin SN, Adachi JD, Papaioannou A, Bessette L, Brown JP, Pericleous L, Muratov S, Hopkins RB - BMC Geriatr (2016)

Health Related Quality of Life (HRQoL) Pre- and Post-Fracture, Hip Fracture, by duration of follow-up censored by death (Home Care and Long-term Care cohorts combined)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837505&req=5

Fig4: Health Related Quality of Life (HRQoL) Pre- and Post-Fracture, Hip Fracture, by duration of follow-up censored by death (Home Care and Long-term Care cohorts combined)
Mentions: Our analyses excluded 967 individuals who died within 36 months following a fracture. For those individuals dying within 36 months after a fracture, the decrement in HRQoL post fracture was overall similar to patients who did not die (Fig. 4). In general, there was a clinically important decrease in HRQoL in the period prior to death for all patients independent of the time of death in the range of 0.33 to 0.37 for all lengths of follow-up.Fig. 4

Bottom Line: The HUI-2, a validated HRQoL instrument, allows the calculation of health utility where 0 represents death and 1 the best imaginable health state.Of the 6 HUI-2 domains, mobility had the largest impact on change in HRQoL.Regression analysis indicated that living with a musculoskeletal disorder or a neurological condition and living in LTC were associated with greater decrements in utility following a fracture.

View Article: PubMed Central - PubMed

Affiliation: Programs for Assessment of Technology in Health (PATH), St. Joseph's Healthcare Hamilton, 25 Main Street West, Suite 2000, Hamilton, ON, L8P 1H1, Canada. tarride@mcmaster.ca.

ABSTRACT

Background: To estimate the long-term change in health related quality of life (HRQoL) following low-trauma fractures among individuals receiving home care (HC) services or living in long-term care (LTC) facilities using linked healthcare administrative data from Ontario, Canada.

Methods: HRQoL was estimated using the Health Utility Index (HUI-2) with the InterRai Minimum Data Set (MDS), a mandatory questionnaire for LTC and HC in the province of Ontario (population 14 million). The HUI-2, a validated HRQoL instrument, allows the calculation of health utility where 0 represents death and 1 the best imaginable health state. For reference, the HUI-2 utility value for Canadians aged 80-84 years is 0.61 and the minimal clinically important difference is 0.03. The MDS was linked to Ontario acute care databases for fiscal years 2007-2011 to identify low-trauma fractures using ICD-10-CA codes. Regression models were used to identify predictors of change in HRQoL from pre-fracture levels to 3 years post fracture for several populations. Low-trauma fractures included hip, humerus, vertebral, wrist, multiple and other.

Results: Twenty-three thousand six-hundred fifty-five unique patients with low-trauma fractures were identified with pre- and post-fracture HRQoL assessments, of which 5057 individuals had at least 3 years of follow-up. Compared to patients receiving HC services (N = 3303), individuals residing in LTC (N = 1754) were older, taking more medications, and had more comorbidities. LTC patients had more hip fractures (49 % of total versus 29 %). For all fracture types, HRQoL decreased immediately following fracture. Although levels rebounded after the first month, HRQoL up to 36 months never returned to pre-fracture levels even for non-hip fracture. For both HC and LTC cohorts, clinically important and statistically significant decreases in HUI-2 utility scores were observed 36 months post fracture. Of the 6 HUI-2 domains, mobility had the largest impact on change in HRQoL. Regression analysis indicated that living with a musculoskeletal disorder or a neurological condition and living in LTC were associated with greater decrements in utility following a fracture.

Conclusions: Based on the analysis of one of the largest studies on HRQoL to date, among individuals living in LTC facilities or receiving HC services, fractures have a significant permanent impact on HRQoL up to 3 years following fracture.

No MeSH data available.


Related in: MedlinePlus