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Health-related quality of life during the first year after a hip fracture: results of the Mexican arm of the International Cost and Utility Related to Osteoporotic Fractures Study (MexICUROS)

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Abstract

Summary

We investigated changes in health-related quality of life (HRQoL) due to hip fracture in Mexican adults aged ≥ 50 years during the first year post-fracture. Mean accumulated loss was 0.27 quality-adjusted life years (QALYs). HRQoL before fracture was the main contributor to explain the loss of QALYs.

Introduction

We aimed to estimate the health-related quality of life (HRQoL) loss over 1 year in patients sustaining a hip fracture in Mexico.

Methods

Individuals aged ≥ 50 years old with diagnosis of a low-energy-induced hip fracture enrolled in the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) composed the study population. After a recall of their own pre-fracture status, HRQoL was prospectively collected in three phases over 12 months of follow-up using EQ-5D-3L. The UK preference weight set was applied to calculate the utility values. The accumulated quality-adjusted life years (QALYs) loss in the first year post-fracture was estimated using the trapezoid method. Multivariate regression analysis allowed identifying determinants of QALYs loss.

Results

One hundred ninety-three patients (mean ± SD age 77.2 ± 9.9 years; 80% women; 15.5% with prior fracture in the last 5 years; 78% in low-income category) were evaluated. Mean (95% CI) utility value before fracture was 0.64 (0.59–0.68). It dropped to 0.01 (0.01–0.02) immediately after fracture and then improved to 0.46 (0.42–0.51) and 0.60 (0.55–0.64) at 4 and 12 months post-fracture, respectively. Disregarding fracture-related mortality, accumulated QALYs loss over the first year was 0.27 (0.24–0.30) QALYs. Mobility, self-care, and usual activities were the most affected domains throughout the whole year. HRQoL before fracture was the main contributor to explain the loss of QALYs.

Conclusions

Hip fractures reduce dramatically the HRQoL, with the loss sustained at least over the first year post-fracture in Mexico. The utility values derived from this study can be used in future economic evaluations.

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Acknowledgments

The authors are grateful to Dr. Alejandro Ríos from Hospital Ángeles Mocel, Dr. Guillermo García Pinto from Hospital Central Militar, Dr. Mauricio Sierra Pérez from Hospital Central Norte de PEMEX, Dr. Federico Cisneros from Hospital de Traumatología y Ortopedia Lomas Verdes IMSS, and Dr. Margarita Valdés and Dr. Eric Hazam from the Instituto Nacional de Rehabilitación Guillermo Ibarra, SS, for their invaluable help in interviewing their patients.

Funding

This study was supported by CONACyT Grant No. 87106.

Author information

Authors and Affiliations

  1. Instituto Tecnológico Autónomo de México, Mexico City, Mexico

    L. Guirant

  2. R A C Salud Consultores, S.A. de C.V., Mexico City, Mexico

    F. Carlos

  3. Faculty of Medicine UNAM, Mexico City, Mexico

    D. Curiel & P. Clark

  4. SSPDF C.S. TII Hortencia, Mexico City, Mexico

    D. Curiel

  5. Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK

    J. A. Kanis

  6. Institute for Health and Ageing, Catholic University of Australia, Melbourne, 3000, Australia

    J. A. Kanis

  7. LIME/MMC, Karolinska Institutet, Stockholm, Sweden

    F. Borgström

  8. Mapi, Stockholm, Sweden

    A. Svedbom

  9. Clinical Epidemiology Unit, Facultad de Medicina UNAM, Hospital Infantil Federico Gómez, Mexico City, Mexico

    P. Clark

Authors
  1. L. Guirant
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  2. F. Carlos
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  3. D. Curiel
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  4. J. A. Kanis
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  5. F. Borgström
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  6. A. Svedbom
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  7. P. Clark
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Corresponding author

Correspondence to P. Clark.

Ethics declarations

The study was conducted in accordance with the declaration of Helsinki, informed consent was obtained from all participants, and the Research and Ethics Committees in each of the participant institutions approved the protocol.

Conflicts of interest

None.

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Guirant, L., Carlos, F., Curiel, D. et al. Health-related quality of life during the first year after a hip fracture: results of the Mexican arm of the International Cost and Utility Related to Osteoporotic Fractures Study (MexICUROS). Osteoporos Int 29, 1147–1154 (2018). https://doi.org/10.1007/s00198-018-4389-9

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