Osteoporosis International

, Volume 15, Issue 2, pp 87–94

Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study

  • Steven Boonen
  • Philippe Autier
  • Martine Barette
  • Dirk Vanderschueren
  • Paul Lips
  • Patrick Haentjens
Original Article

DOI: 10.1007/s00198-003-1515-z

Cite this article as:
Boonen, S., Autier, P., Barette, M. et al. Osteoporos Int (2004) 15: 87. doi:10.1007/s00198-003-1515-z

Abstract

The aim of this prospective study was to document the functional outcome and quality of life (QoL) over 1 year following hip fracture in elderly women. A total of 159 unselected elderly women with a first hip fracture were matched for age and residence with an equal number of control women. Functional status was measured by completing a Rapid Disability Rating Scale version 2 (RDRS-2) questionnaire [score ranging from 0 (best) to 54 (worse)], before hospital discharge and 12 months later. To examine longitudinal change in health-related QoL, fracture subjects and controls completed the Short Form 36 (SF-36) questionnaire. For the 134 women still alive at 1 year, the mean RDRS-2 score before hospital discharge was 16.2 (95% CI: 15.0–18.0) and 3.5 (2.6–4.3) in patients and controls, respectively (P<0.001). During the year following hospital discharge, the mean RDRS-2 score improved to 13.0 (11.1–14.1) in hip-fracture women and worsened to 4.3 (3.3–5.0) in the control group (differences with initial scores: P<0.001 in both groups). After adjustment for potential confounders (including age and comorbidity), the estimated functional decline attributable to a hip fracture was 24% in the first year. Poor functional status upon discharge was the strongest predictor of a poor functional status at 1 year. Overall, similar trends were observed when using SF-36 scores as compared with RDRS-2 scores. However, only 51% of the study population was able to complete the SF-36 questionnaire at discharge and after 1 year, and these subjects were considerably younger (P<0.001), had less cognitive impairment (P<0.001), and had better functional status (P<0.001) than those who were unable to complete the SF-36. For those women able to complete the SF-36 questionnaires, the mean SF-36 score before hospital discharge was 56.4 (95% CI: 51.9–60.9) and 71.1 (67.5–74.8) in patients and controls, respectively (P<0.001). During the year following hospital discharge, the mean SF-36 score improved significantly to 61.1 (56.5–65.7) in hip-fracture patients (P=0.03), but remained unchanged in the control group (P=0.23). Overall, the results of this study indicate that women who sustain a hip fracture continue to suffer from substantial functional impairment and loss in QoL at 1 year, despite a significant recovery during this 12-month period. Function upon hospital discharge is the strongest predictor of functional status 1 year later. Assessing QoL in hip fracture women through self-administered questionnaires is subject to considerable bias due to non-response.

Keywords

Elderly womenFunctional outcomeHip fractureQuality of life

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • Steven Boonen
    • 1
  • Philippe Autier
    • 2
    • 3
  • Martine Barette
    • 4
  • Dirk Vanderschueren
    • 5
  • Paul Lips
    • 6
  • Patrick Haentjens
    • 7
  1. 1.Leuven University Center for Metabolic Bone Diseases and Division of Geriatric MedicineKatholieke Universiteit LeuvenLeuvenBelgium
  2. 2.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanItaly
  3. 3.Center of Epidemiology and Biostatistics of the Luxembourg Health InstituteLuxemburgGrand Duchy of Luxemburg
  4. 4.Unit of Epidemiology and Prevention of CancerJules Bordet InstituteBrusselsBelgium
  5. 5.Division of EndocrinologyKatholieke Universiteit LeuvenLeuvenBelgium
  6. 6.Department of EndocrinologyVrije Universiteit Medical CenterAmsterdamThe Netherlands
  7. 7.Department of Orthopaedics and Traumatology, Academisch Ziekenhuis VUBVrije Universiteit BrusselBrusselsBelgium