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Predictors for quality of life improvement after acute osteoporotic vertebral fracture: results of post hoc analysis of a prospective randomized study

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Abstract

Purpose

No study has investigated the clinical and radiographic risk factors for the deterioration of quality of life (QOL) beyond 6 months after osteoporotic vertebral fractures (OVF). The purpose of this study was to identify the predictors associated with poor QOL improvement after OVF.

Methods

This post hoc analysis included 166 women aged 65–85 years with acute 1-level OVFs. For the patient-reported outcome measures, scores on the European Quality of Life-5 Dimensions (EQ-5D) scale, and visual analogue scale (VAS) for low back pain were used. Lateral radiography at 0, 12, and 48 weeks and magnetic resonance imaging (MRI) at enrollment and at 48 weeks were performed. The associations between baseline variables with change scores for EQ-5D were investigated using a multiple linear regression model.

Results

Univariate analysis showed that time since fracture, EQ-5D score, and VAS for low back pain at 0 week showed significant association with increased EQ-5D score from 0 to 48 weeks. According to the multiple regression analysis, the following equation was obtained: increased EQ-5D score from 0 to 48 weeks = 1.305 – 0.978 × EQ-5D at 0 week – 0.021 × VAS for low back pain at 0 week – 0.006 × age + (fluid-intensity T2-weighted MR image patterns: − 0.037, except for fluid-intensity T2-weighted MR image patterns: + 0.037).

Conclusion

In conclusion, older patients with severe low back pain and fluid-intensity T2-weighted MR image patterns were more likely to have lower QOL improvements after OVFs and may therefore need extra support to improve QOL

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Funding

This work was supported by Grants-in-Aid from the Japan Agency for Medical Research and Development (Grant Number 16dk0110008h0003, to AO).

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Authors and Affiliations

  1. Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo, 108-0075, Japan

    Hiroyuki Inose, Tsuyoshi Kato, Masato Yuasa, Takashi Hirai, Toshitaka Yoshii & Atsushi Okawa

  2. Department of Orthopaedics, Ome Municipal General Hospital, Tokyo, 198-0042, Japan

    Tsuyoshi Kato

  3. Department of Orthopedic Surgery, Graduate School of Medicine, Osaka City University, Osaka, 545-8585, Japan

    Hiroaki Nakamura & Masatoshi Hoshino

  4. Department of Orthopaedic Surgery, Hamamatsu University of Medicine, Shizuoka, 431-3192, Japan

    Daisuke Togawa

  5. Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan

    Toru Hirano

  6. Department of Orthopaedic Surgery, Nihon University, Tokyo, 173-8610, Japan

    Yasuaki Tokuhashi

  7. Department of Orthopaedic Surgery, University of Yamanashi, Yamanashi, 409-3898, Japan

    Tetsuro Ohba & Hirotaka Haro

  8. Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, 108-8642, Japan

    Takashi Tsuji

  9. Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume University, Fukuoka, 830-0011, Japan

    Kimiaki Sato

  10. Department of Orthopaedic Surgery, Graduate School, School of Medicine, St. Marianna University, Kanagawa, 216-8511, Japan

    Yutaka Sasao

  11. Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido, 060-8638, Japan

    Masahiko Takahata

  12. Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan

    Koji Otani

  13. Department of Diagnostic Radiology, Center for Preventive Medicine, Keio University School of Medicine, Tokyo, 160-8582, Japan

    Suketaka Momoshima

  14. Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, 108-0075, Japan

    Kunihiko Takahashi

  15. Department of Orthopedic and Trauma Research, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Hiroyuki Inose

Authors
  1. Hiroyuki Inose
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  2. Tsuyoshi Kato
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  3. Hiroaki Nakamura
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  4. Masatoshi Hoshino
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  5. Daisuke Togawa
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  6. Toru Hirano
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  7. Yasuaki Tokuhashi
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  8. Tetsuro Ohba
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  9. Hirotaka Haro
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  10. Takashi Tsuji
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  11. Kimiaki Sato
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  12. Yutaka Sasao
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  13. Masahiko Takahata
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  14. Koji Otani
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  15. Suketaka Momoshima
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  16. Kunihiko Takahashi
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  17. Masato Yuasa
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  18. Takashi Hirai
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  19. Toshitaka Yoshii
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  20. Atsushi Okawa
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Contributions

HI, TK, HN, MH, DT, ToH, YT, TO, HH, TT, KS, YS, MT, KO, SM, KT, MY, TaH, TY, and AO (1) provided substantial contributions to the conception or design of the study or the acquisition, analysis, or interpretation of data; (2) drafted the paper or revised it critically for important intellectual content; (3) provided final approval of the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Hiroyuki Inose.

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Conflict of interest

Hiroyuki Inose, Tsuyoshi Kato, Hiroaki Nakamura, Masatoshi Hoshino, Daisuke Togawa, Toru Hirano, Yasuaki Tokuhashi, Tetsuro Ohba, Hirotaka Haro, Takashi Tsuji, Kimiaki Sato, Yutaka Sasao, Masahiko Takahata, Koji Otani, Suketaka Momoshima, Kunihiko Takahashi, Masato Yuasa, Takashi Hirai, Toshitaka Yoshii, and Atsushi Okawa declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all participants included in the study.

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Written informed consent was obtained from the patients for publication.

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Inose, H., Kato, T., Nakamura, H. et al. Predictors for quality of life improvement after acute osteoporotic vertebral fracture: results of post hoc analysis of a prospective randomized study. Qual Life Res 30, 129–135 (2021). https://doi.org/10.1007/s11136-020-02629-9

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  • DOI: https://doi.org/10.1007/s11136-020-02629-9

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