Impact of Prevalent Fractures on Quality of Life: Baseline Results From the Global Longitudinal Study of Osteoporosis in Women
Impact of Prevalent Fractures on Quality of Life: Baseline Results From the Global Longitudinal Study of Osteoporosis in Women
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DOI：
10.4065/mcp.2010.0082
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发表时间：
2010-09-01
影响因子：
8.9
通讯作者：
Watts, Nelson B.
中科院分区：
文献类型：
--
作者：
Adachi, Jonathan D.;Adami, Silvano;Watts, Nelson B.
目的：通过与其他慢性疾病(糖尿病、关节炎、肺部疾病)的比较，对既往有骨折病史的绝经后妇女的健康相关生活质量(HRQL)的几个维度进行考察，并提供观点。很少有研究考察既往有骨折史的女性的HRQL，以及既往骨折部位对HRQL的影响。在这项观察性研究中，来自10个国家的17个研究地点的57,141名55岁及以上的绝经后妇女(从2007年12月到2009年3月登记)，使用欧洲生活质量5维指数(EQ-5D)和医疗结果研究36项简短健康调查(SF-36)的健康状况、身体功能和活力问题来测量HRQL。结果：EQ-5D健康效用得分和SF-36测量的健康状况、身体功能和活力与10个骨折部位中的9个相关。脊柱、髋部和大腿骨折导致的生活质量下降最大(EQ-5D评分分别为0.62、0.64和0.61，而未骨折者为0.79)。在上述3个部位中任一处有骨折史的女性，以及有多处骨折病史的女性(EQ-5D评分，1处骨折为0.74分，2处骨折为0.68分，0.58分为3分)，其HRQL的降低程度与其他慢性病患者相似或更差(糖尿病为0.67分，关节炎为0.69分，肺部疾病为0.71分)。结论：既往各种骨骼部位的骨折，特别是脊柱、髋部和大腿骨折，或累及1个以上部位的骨折患者的生活质量显著降低。
OBJECTIVE: To examine several dimensions of health-related quality of life (HRQL) in postmenopausal women who report previous fractures, and to provide perspective by comparing these findings with those in other chronic conditions (diabetes, arthritis, lung disease).PATIENTS AND METHODS: Fractures are a major cause of morbidity among older women. Few studies have examined HRQL In women who have had prior fractures and the effect of prior fracture location on HRQL. In this observational study of 57,141 postmenopausal women aged 55 years and older (enrollment from December 2007 to March 2009) from 17 study sites in 10 countries, HRQL was measured using the European Quality of Life 5 Dimensions Index (EQ-5D) and the health status, physical function, and vitality questions of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).RESULTS: Reductions in EQ-5D health-utility scores and SF-36 measured health status, physical function, and vitality were seen in association with 9 of 10 fracture locations. Spine, hip, and upper leg fractures resulted in the greatest reductions In quality of life (EQ-5D scores, 0.62, 0.64, and 0.61, respectively, vs 0.79 without prior fracture). Women with fractures at any of these 3 locations, as well as women with a history of multiple fractures (EQ-5D scores, 0.74 for 1 prior fracture, 0.68 for 2, and 0.58 for >= 3), had reductions in HRQL that were similar to or worse than those in women with other chronic diseases (0.67 for diabetes, 0.69 for arthritis, and 0.71 for lung disease).CONCLUSION: Previous fractures at a variety of bone locations, particularly spine, hip, and upper leg, or involving more than 1 location are associated with significant reductions in quality of life.