Incident Fragility Fractures Have a Long-Term Negative Impact on Health-Related Quality of Life of Older People: The Canadian Multicentre Osteoporosis Study
Incident Fragility Fractures Have a Long-Term Negative Impact on Health-Related Quality of Life of Older People: The Canadian Multicentre Osteoporosis Study
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DOI：
10.1002/jbmr.3666
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发表时间：
2019-05-01
影响因子：
6.2
通讯作者：
Leslie, William D.
中科院分区：
文献类型：
--
作者：
Borhan, Sayem;Papaioannou, Alexandra;Leslie, William D.
虽然脆性骨折对老年人健康相关生活质量（HRQL）的短期影响已得到证实，但我们缺乏长期证据。我们使用加拿大多中心骨质疏松研究（CaMos）的10年前瞻性数据，探讨了50岁及以上人群中偶发脆性骨折对HRQL的影响。该研究基于7753名CaMos参与者（2187名男性和5566名女性）的数据。通过健康效用指数（HUI）测量的HRQL在基线和第10年获得。在10年的随访中，记录了脊柱、髋关节、肋骨、肩部、骨盆或前臂的脆性骨折事件。进行多变量回归分析，以测量骨折和未骨折参与者的HUI评分的平均差异，称为赤字。我们研究了单一或多个脆性骨折、时间（骨折发生在1 - 5年和6 - 10年之间）和恢复到骨折前水平的影响。脊柱和髋部骨折的发生与HUI评分的显著缺陷（从-0.19到-0.07不等）相关。髋关节和脊柱骨折对活动性、自我护理和截肢有负面影响。与之前很长时间发生的骨折相比，更接近随访评估发生的骨折对HRQL有显著影响，但髋部骨折除外（缺陷持续5年或更长时间）。同样，多髋（-0.14），脊柱（-0.16）和肋骨（-0.21）骨折显着影响女性的HRQL。髋部骨折的女性从未恢复到骨折前的水平评分（OR = 0.41; 95%置信区间[CI]，0.19 - 0.98）。我们的分析表明，单髋和多髋骨折以及多个脊柱和肋骨骨折强烈影响老年人的HRQL在很长一段时间。(c)2019年美国骨与矿物质研究学会。
Although the short-term impact of incident fragility fractures on health-related quality of life (HRQL) of older people has been confirmed, we lack long-term evidence. We explored the impact of incident fragility fractures on HRQL, among people aged 50 years and older, using 10-year prospective data from the Canadian Multicentre Osteoporosis Study (CaMos). This study was based on data from 7753 (2187 men and 5566 women) participants of CaMos. The HRQL, measured through the Health Utility Index (HUI), was captured at baseline and year 10. The incident fragility fractures were recorded over 10 years of follow-up at spine, hip, rib, shoulder, pelvis, or forearm. Multivariable regression analysis was conducted to measure the mean difference, termed as deficit, in the HUI scores for participants with and without fractures. We examined the effects of single or multiple fragility fractures, time (fractures that occurred between year 1 to 5 and 6 to 10) and recovery to the prefracture level. Incident spine and hip fractures were associated with significant deficits (varied from -0.19 to -0.07) on the HUI scores. Hip and spine fractures were associated with negative impact on mobility, self-care, and ambulation. Fractures that occurred closer to the follow-up assessment were associated with significant impact on HRQL compared to fractures occurring a long time before it, except for hip fracture (deficits lasted 5 years or longer). Similarly, multiple hip (-0.14), spine (-0.16), and rib (-0.21) fractures significantly impacted the HRQL of women. Women with a hip fracture never recovered to their prefracture level score (OR = 0.41; 95% confidence interval [CI], 0.19 to 0.98). Our analysis suggests that single and multiple hip fractures as well as multiple spine and rib fractures strongly impact the HRQL of older people over a prolonged period of time. (c) 2019 American Society for Bone and Mineral Research.