Abstract
Introduction
The number of hip fracture patients is expected to grow the forthcoming decades. Knowledge of the impact of the fracture on the lives of elderly could help us target our care. The aim of the study is to describe HRQoL (Health-Related Quality of Life) after a hip fracture and to identify factors associated with the course of HRQoL in the first postoperative year.
Materials and methods
335 surgically treated hip fracture patients (mean age 79.4 years, SD 10.7, 68 % female) were included in a prospective observational cohort. HRQoL was measured with the SF-12 Health Survey, composed of the Physical and a Mental Component Summary Score (PCS, MCS), at admission (baseline) and at 3 and 12 months postoperatively. Eleven predefined factors known to be associated with the course of HRQoL were recorded: age, gender, physical status, having a partner at admission, living in an institution, prefracture level of mobility, anemia, type of fracture and treatment, delirium during hospital stay and length of stay.
Results
HRQoL declined between baseline and 3 months, and recovered between three and 12 months. PCS HRQoL did not recover to baseline values, MCS HRQoL did. Age younger than 80 years, ASA classification I and II, higher prefracture level of mobility, intracapsular fracture and treatment with osteosynthesis (compared to arthroplasty) were associated with greater initial decline in PCS HRQoL, none of the recorded factors were significant for decline in MCS HRQoL.
Conclusions
Both PCS and MCS HRQoL declined after a hip fracture and PCS did not recover to baseline values. Healthier patients may need extra care to prevent them from having a steep decline in postoperative PCS HRQoL and arthroplasty should be considered with low threshold.
Similar content being viewed by others
References
Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos 8:136
Vochteloo AJ, Moerman S, Tuinebreijer WE et al (2012) More than half of hip fracture patients do not regain mobility in the first postoperative year. Geriatr Gerontol Int 2:334–341
Bentler SE, Liu L, Obrizan M et al (2009) The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 170:1290–1299
Vochteloo AJH, van Vliet-Koppert ST, Maier AB et al (2012) Risk factors for failure to return to the pre-fracture place of residence after hip fracture: a prospective longitudinal study of 444 patients. Arch Orthop Trauma Surg 132:823–830
Bond J, Gregson B, Smith M et al (2000) Predicting place of discharge from hospital for patients with a stroke or hip fracture on admission. J Health Serv Res Policy 5:133
Peterson M, Allegrante J, Cornell C et al (2002) Measuring recovery after a hip fracture using the SF-36 and Cummings scales. Osteoporos Int 13:296–302
Adachi JD, Ioannidis G, Berger C et al (2001) International original article the influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across canada. pp 903–908
Hallberg I, Bachrach-Lindström M, Hammerby S et al (2009) Health-related quality of life after vertebral or hip fracture: a seven-year follow-up study. BMC Musculoskelet Disord 10:135
Brenneman SK, Barrett-connor E, Sajjan S et al (2006) Impact of recent fracture on health-related quality of life in postmenopausal women. J Bone Miner Res 21:809–816
Randell AG, Nguyen TV, Bhalerao N et al (2000) Deterioration in quality of life following hip fracture: A prospective study. Osteoporos Int pp 460–466
Tidermark J, Zethraeus N, Svensson O et al (2002) Femoral neck fractures in the elderly: functional outcome and quality of life according to EuroQol. Qual Life Res 11:473–481
Rohde G, Haugeberg G, Mengshoel AM et al (2010) Two-year changes in quality of life in elderly patients with low-energy hip fractures, A case-control study. BMC Musculoskelet Disord 11:226
Shyu Y-IL, Chen M-C, Liang J et al (2004) Changes in quality of life among elderly patients with hip fracture in Taiwan. Osteoporos Int 15:95–102
Pande I, Scott DL, O’Neill TW et al (2006) Quality of life, morbidity, and mortality after low trauma hip fracture in men. Ann Rheum Dis 65:87–92
Borgström F, Lekander I, Ivergård M et al (2013) The international costs and utilities related to osteoporotic fractures study (ICUROS)–quality of life during the first 4 months after fracture. Osteoporos Int 24:811–823
Borgström F, Zethraeus N, Johnell O et al (2006) Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 17:637–650
Hallberg I, Rosenqvist AM, Kartous L et al (2004) Health-related quality of life after osteoporotic fractures. Osteoporos Int 15:834–841
Gjertsen J-E, Vinje T, Lie SA et al (2008) Patient satisfaction, pain, and quality of life 4 months after displaced femoral neck fractures: a comparison of 663 fractures treated with internal fixation and 906 with bipolar hemiarthroplasty reported to the Norwegian Hip Fracture Register. Acta Orthop 79:594–601
Peasgood T, Herrmann K, Kanis JA, Brazier JE (2009) An updated systematic review of Health State Utility Values for osteoporosis related conditions. Osteoporos Int 20:853–868
Marsh JL, Slongo T, Agel J et al (2007) Fracture and dislocation classification compendium—2007. J Orthop Trauma 21:1–6
Parker SG, Bechinger-English D, Jagger C et al (2006) Factors affecting completion of the SF-36 in older people. Age Ageing 35:376–381
DSM IV-R D (2000) Statistical manual of mental disorders, text revision (DSM IV–R). Washingt DC Am Psychiatry, Assoc
Vochteloo AJH, Niesten D, Cornelisse H et al (2009) Voor elke heup een rode map. Med Contact (Bussum) 158–162
Owens W, Felts J (1978) ASA physical status classifications: a study of consistency of ratings. Anesthesiology 49:239–243
(1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37
Mols F, Pelle AJ, Kupper N (2009) Normative data of the SF-12 health survey with validation using postmyocardial infarction patients in the Dutch population. Qual Life Res 18:403–414
Vander Zee KI, Sanderman R, Heyink JW, de Haes H (1996) Psychometric qualities of the RAND 36-Item Health Survey 1.0: a multidimensional measure of general health status. Int J Behav Med 3:104–122
Agel J, Swiontkowski M (2006) Guide to outcomes instruments for musculoskeletal trauma research—PubMed—NCBI. J Orthop Trauma 20:1–146
Gandhi SK, Salmon JW, Zhao SZ et al (2001) Psychometric evaluation of the 12-item short-form health survey (SF-12) in osteoarthritis and rheumatoid arthritis clinical trials. Clin Ther 23:1080–1098
Beaupre LA, Jones CA, Johnston DWC et al (2012) Recovery of function following a hip fracture in geriatric ambulatory persons living in nursing homes: prospective cohort study. JAGS 60:1268–1273
Boonen S, Autier P, Barette M et al (2004) Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study. Osteoporos Int 15:87–94
Koval KJ, Aharonoff GB, Rokito AS et al (1996) Patients with femoral neck and intertrochanteric fractures. Are they the same? Clin Orthop Relat Res 166–72
Parker M, Pryor G, Anand J (1992) A comparison of presenting characteristics of patients with intracapsular and extracapsular proximal femoral fractures. J Royal Soc Med 85:152–155
Fox KM, Magaziner J, Hebel JR et al (1999) Intertrochanteric versus femoral neck hip fractures: differential characteristics, treatment, and sequelae. J Gerontol A Biol Sci Med Sci 54:M635–M640
Buecking B, Struewer J, Waldermann A et al (2014) What determines health-related quality of life in hip fracture patients at the end of acute care?–a prospective observational study. Osteoporos Int 25:475–484
Haleem S, Lutchman L, Mayahi R et al (2008) Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 39:1157–1163
Marsh J, Bryant D, MacDonald SJ (2009) Older patients can accurately recall their preoperative health status 6 weeks following total hip arthroplasty. J Bone Joint Surg Am 91:2827–2837
Schmier JK, Halpern MT (2004) Patient recall and recall bias of health state and health status. Expert Rev Pharmacoecon Outcomes Res 4:159–163
Revicki DA, Turner R, Brown R, Martindale JJ (1992) Reliability and validity of a health-related quality of life battery for evaluating outpatient antidepressant treatment. Qual Life Res 1:257–266
Van Beeck EF, Larsen CF, Lyons RA et al (2007) Guidelines for the conduction of follow-up studies measuring injury-related disability. J Trauma 62:534–550
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The department of orthopaedic surgery and the orthopaedic research foundation in Reinier de Graaf Hospital receive grants from Zimmer Biomet. Each author certifies that he or she and members, or a member of his/her immediate family, have no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose as a conflict of interest in connection with the content of the submitted article.
Rights and permissions
About this article
Cite this article
Moerman, S., Vochteloo, A.J.H., Tuinebreijer, W.E. et al. Factors associated with the course of health-related quality of life after a hip fracture. Arch Orthop Trauma Surg 136, 935–943 (2016). https://doi.org/10.1007/s00402-016-2474-0
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-016-2474-0