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Archives of Orthopaedic and Trauma Surgery

, Volume 136, Issue 7, pp 935–943 | Cite as

Factors associated with the course of health-related quality of life after a hip fracture

  • Sophie MoermanEmail author
  • Anne J. H. Vochteloo
  • Wim E. Tuinebreijer
  • Andrea B. Maier
  • Nina M. C. Mathijssen
  • Rob G. H. H. Nelissen
Trauma Surgery

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.

Keywords

Function Geriatric fracture Hip fracture Outcome Quality of life SF 12 

Notes

Compliance with ethical standards

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.

References

  1. 1.
    Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos 8:136CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    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 2:334–341Google Scholar
  3. 3.
    Bentler SE, Liu L, Obrizan M et al (2009) The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 170:1290–1299CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    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 132:823–830CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    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 5:133PubMedGoogle Scholar
  6. 6.
    Peterson M, Allegrante J, Cornell C et al (2002) Measuring recovery after a hip fracture using the SF-36 and Cummings scales. Osteoporos Int 13:296–302CrossRefPubMedGoogle Scholar
  7. 7.
    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 903–908Google Scholar
  8. 8.
    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 10:135CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    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 21:809–816CrossRefPubMedGoogle Scholar
  10. 10.
    Randell AG, Nguyen TV, Bhalerao N et al (2000) Deterioration in quality of life following hip fracture: A prospective study. Osteoporos Int pp 460–466Google Scholar
  11. 11.
    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 11:473–481CrossRefPubMedGoogle Scholar
  12. 12.
    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 11:226CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    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 15:95–102CrossRefPubMedGoogle Scholar
  14. 14.
    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 65:87–92CrossRefPubMedGoogle Scholar
  15. 15.
    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 24:811–823CrossRefPubMedGoogle Scholar
  16. 16.
    Borgström F, Zethraeus N, Johnell O et al (2006) Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 17:637–650CrossRefPubMedGoogle Scholar
  17. 17.
    Hallberg I, Rosenqvist AM, Kartous L et al (2004) Health-related quality of life after osteoporotic fractures. Osteoporos Int 15:834–841CrossRefPubMedGoogle Scholar
  18. 18.
    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 79:594–601CrossRefPubMedGoogle Scholar
  19. 19.
    Peasgood T, Herrmann K, Kanis JA, Brazier JE (2009) An updated systematic review of Health State Utility Values for osteoporosis related conditions. Osteoporos Int 20:853–868CrossRefPubMedGoogle Scholar
  20. 20.
    Marsh JL, Slongo T, Agel J et al (2007) Fracture and dislocation classification compendium—2007. J Orthop Trauma 21:1–6CrossRefGoogle Scholar
  21. 21.
    Parker SG, Bechinger-English D, Jagger C et al (2006) Factors affecting completion of the SF-36 in older people. Age Ageing 35:376–381CrossRefPubMedGoogle Scholar
  22. 22.
    DSM IV-R D (2000) Statistical manual of mental disorders, text revision (DSM IV–R). Washingt DC Am Psychiatry, AssocGoogle Scholar
  23. 23.
    Vochteloo AJH, Niesten D, Cornelisse H et al (2009) Voor elke heup een rode map. Med Contact (Bussum) 158–162Google Scholar
  24. 24.
    Owens W, Felts J (1978) ASA physical status classifications: a study of consistency of ratings. Anesthesiology 49:239–243CrossRefPubMedGoogle Scholar
  25. 25.
    (1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37Google Scholar
  26. 26.
    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 18:403–414CrossRefPubMedGoogle Scholar
  27. 27.
    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 3:104–122CrossRefGoogle Scholar
  28. 28.
    Agel J, Swiontkowski M (2006) Guide to outcomes instruments for musculoskeletal trauma research—PubMed—NCBI. J Orthop Trauma 20:1–146CrossRefGoogle Scholar
  29. 29.
    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 23:1080–1098CrossRefPubMedGoogle Scholar
  30. 30.
    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 60:1268–1273CrossRefGoogle Scholar
  31. 31.
    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 15:87–94CrossRefPubMedGoogle Scholar
  32. 32.
    Koval KJ, Aharonoff GB, Rokito AS et al (1996) Patients with femoral neck and intertrochanteric fractures. Are they the same? Clin Orthop Relat Res 166–72Google Scholar
  33. 33.
    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 85:152–155Google Scholar
  34. 34.
    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–M640CrossRefPubMedGoogle Scholar
  35. 35.
    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 25:475–484CrossRefPubMedGoogle Scholar
  36. 36.
    Haleem S, Lutchman L, Mayahi R et al (2008) Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 39:1157–1163CrossRefPubMedGoogle Scholar
  37. 37.
    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 91:2827–2837CrossRefPubMedGoogle Scholar
  38. 38.
    Schmier JK, Halpern MT (2004) Patient recall and recall bias of health state and health status. Expert Rev Pharmacoecon Outcomes Res 4:159–163CrossRefPubMedGoogle Scholar
  39. 39.
    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 1:257–266CrossRefPubMedGoogle Scholar
  40. 40.
    Van Beeck EF, Larsen CF, Lyons RA et al (2007) Guidelines for the conduction of follow-up studies measuring injury-related disability. J Trauma 62:534–550CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Sophie Moerman
    • 1
    Email author
  • Anne J. H. Vochteloo
    • 2
  • Wim E. Tuinebreijer
    • 3
  • Andrea B. Maier
    • 4
  • Nina M. C. Mathijssen
    • 1
  • Rob G. H. H. Nelissen
    • 5
  1. 1.Department of Orthopedic SurgeryReinier de Graaf GroupDelftThe Netherlands
  2. 2.Centre for Orthopedic Surgery OCONHengeloThe Netherlands
  3. 3.Department of Surgery-TraumatologyErasmus MC, University Medical Centre RotterdamRotterdamThe Netherlands
  4. 4.Department of Internal MedicineSection of Gerontology and Geriatrics, VU University Medical CentreAmsterdamThe Netherlands
  5. 5.Department of Orthopedic Surgery Leiden University Medical CentreLeidenThe Netherlands

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