Osteoporosis International

, Volume 24, Issue 3, pp 811–823 | Cite as

The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)—quality of life during the first 4 months after fracture

  • F. BorgströmEmail author
  • I. Lekander
  • M. Ivergård
  • O. Ström
  • A. Svedbom
  • V. Alekna
  • M. L. Bianchi
  • P. Clark
  • M. D. Curiel
  • H. P. Dimai
  • M. Jürisson
  • R. Kallikorm
  • O. Lesnyak
  • E. McCloskey
  • E. Nassonov
  • K. M. Sanders
  • S. Silverman
  • M. Tamulaitiene
  • T. Thomas
  • A. N. A. Tosteson
  • B. Jönsson
  • J. A. Kanis
Original Article



The quality of life during the first 4 months after fracture was estimated in 2,808 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss.


The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS.


ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire.


The total sample for the analysis was 2,808 patients (1,273 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not.


The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries.


Costs Fracture Osteoporosis Quality of life 



We are grateful to the Quality of Life and Epidemiology Working Group1 of the Committee of Scientific Advisors for the International Osteoporosis Foundation under whose supervision this study was undertaken. The ICUROS is sponsored by Amgen, Eli Lilly, Medtronic (formerly Kyphon), Novartis, Sanofi-Aventis, Servier and Wyeth. In Australia, the study is supported by project grant no. 628422 from the National Health and Medical Research Council. In Austria, the study is sponsored by Central Association of Austrian Social Security Institution (Hauptverband der österreichischen Sozialversicherungsträger), Austrian Society for Bone and Mineral Research (AuSBMR), Merck Sharp & Dohme, Servier GmbH, Medtronic (formerly Kyphon) GmbH, Amgen GmbH, Novartis GmbH, Nycomed GmbH, Roche GmbH, Sanofi-Aventis GmbH and Daiichi-Sankyo GmbH. In Mexico, the study was supported by CONACyT grant number El 2008-01-87106, and we are grateful to Gabriela Chico Master Student Mexico City, Fernando Carlos MHE Mexico City. In Lithuania, the work was supported by National Osteoporosis Center and gratitude is extended to Maryte Garliene for skilful technical assistance. In the Russia, the following team members provided valuable contributions to the study: Dr. Natalia Toroptsova, Dr. Oxana Nikitinskaya, Dr. Olga Dobrovolskaya (Institute of Rheumatology, RAMS, Moscow), Prof. Larissa Menshikova, Dr. Julia Varavko (Medical Institute of Postgraduate Training, Irkutsk), Prof. Olga Ershova, Dr. Ksenia Belova (Yaroslavl State Medical Academy, Yaroslavl), Dr. Alexander Solodovnikov, Dr. Ksenia Usenko (Ural State Medical Academy, Yekaterinburg), Prof. Georgij Golubev, Dr. Vyacheslav Grebenshikov (Rostov-on-Don State Medical University, Rostov-on-Don), Prof. Eugenij Zotkin, Dr. Irina Zubkova (North-West Federal Medical University, Saint-Petersburg), Prof. Alexander Kochish, Dr. Sergej Ivanov (Vreden Institute of Traumatology and Orthopedics, Saint-Petersburg) and Dr. Radik Nurligayanov (City Clinical Hospital # 21, Ufa). In the USA, Amgen Inc., Ingenix Pharmaceutical Services, Eli Lilly and Company, Medtronic Spine LLC and Wyeth Pharmaceuticals Inc. sponsored the study. Hoffmann La Roche and Amgen provided support. In Estonia the study was supported by Estonian Science Foundation grant # 9368.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • F. Borgström
    • 1
    Email author
  • I. Lekander
    • 1
  • M. Ivergård
    • 2
  • O. Ström
    • 1
  • A. Svedbom
    • 2
  • V. Alekna
    • 3
    • 4
  • M. L. Bianchi
    • 5
  • P. Clark
    • 6
  • M. D. Curiel
    • 7
    • 8
  • H. P. Dimai
    • 9
  • M. Jürisson
    • 10
  • R. Kallikorm
    • 10
  • O. Lesnyak
    • 11
  • E. McCloskey
    • 12
  • E. Nassonov
    • 13
  • K. M. Sanders
    • 14
  • S. Silverman
    • 15
  • M. Tamulaitiene
    • 3
  • T. Thomas
    • 16
  • A. N. A. Tosteson
    • 17
  • B. Jönsson
    • 18
  • J. A. Kanis
    • 19
  1. 1.LIME/MMCKarolinska InstitutetStockholmSweden
  2. 2.OptumInsightStockholmSweden
  3. 3.Faculty of MedicineVilnius UniversityVilniusLithuania
  4. 4.State Research Institute Center for Innovative MedicineVilniusLithuania
  5. 5.Bone Metabolism UnitIstituto Auxologico Italiano IRCCSMilanItaly
  6. 6.Clinical Epidemiology Unit, Hospital Infantil Federico Gómez and Faculty of MedicineUNAMMexico CityMexico
  7. 7.Servicio de Medicina Interna/Enfermedades Metabolicas OseasFundacion Jimenez DiazMadridSpain
  8. 8.Catedra de Enfermedades Metabolicas ÓseasUniversidad AutonomaMadridSpain
  9. 9.Medical University of GrazGrazAustria
  10. 10.Faculty of MedicineTartu UniversityTartuEstonia
  11. 11.Ural State Medical AcademyYekaterinburgRussia
  12. 12.Academic Unit of Bone Metabolism, Metabolic Bone CentreUniversity of SheffieldSheffieldUK
  13. 13.FSBI Research Institute of RheumatologyRAMSMoscowRussia
  14. 14.Department of Medicine, NorthWest Academic CentreThe University of Melbourne, Western HealthMelbourneAustralia
  15. 15.Cedars-Sinai Medical CenterLos AngelesUSA
  16. 16.INSERM U1059CHU-St-EtienneSaint EtienneFrance
  17. 17.The Dartmouth Institute for Health Policy and Clinical PracticeGeisel School of Medicine at DartmouthLebanonUSA
  18. 18.Stockholm School of EconomicsStockholmSweden
  19. 19.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of SheffieldSheffieldUK

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