HEALTH RELATED QUALITY OF LIFE 12 MONTHS AFTER VERTEBRAL FRACTURE
Violeta Sinkevičienė , Vidmantas Alekna , Danutė Kalibatienė , Marija Tamulaitienė 1,2
1,2
1
1,2
1 Vilnius University Faculty of Medicine, 2 National Osteoporosis Center
INTRODUCTION
The vertebral body fracture is the most frequent type of osteoporotic fracture [1]. Osteoporosis and associated fractures are a major public health concern because of related morbidity and disability, decreased quality of life and mortality [2]. Vertebral fractures are the hallmark of osteoporosis, it may be minor and pass unnoticed, or they may lead
to long-term immobility and disability [3]. It is well known and frequently reported that the vertebral body fracture causes pain, disability and has a negative effect on the patient’s health-related quality of life [4].
STUDY OBJECTIVES
To assess health-related quality of life 12 months after vertebral fracture.
METHODS AND MATERIALS
Subjects aged 50 years and more who sustained vertebral fracture confirmed by x-ray were included in this study. Within 14 days after the visit to the hospital emergency unit or outpatient department, all eligible patients received written information about the study and invitation to participate. The patients who agreed to participate were asked to answer the questionnaire. The EQ-5D questionnaire was used to evaluate daily living
activities, mobility, self care, usual activities, pain/discomfort, and anxiety/depression. Subjects were investigated two times: interviewed at the hospital, immediately after the fracture and 12 months after the fracture - by phone. Statistical analysis was performed using SPSS software version 18.0 for Windows.
RESULTS
A total of 82 persons with average age of 66.54 ± 10.57 years were included in this study: 63 (76.8 %) women and 19 (23.2 %) men. The average of the quality of life before the fracture was of 5.74 ± 1.38 points and after 12 months - 8.28 ± 2.03 points, as assessed by EQ-5D questionnaire (p <0.01). Table 1. The average of the quality of life before the fracture and at the 12 months follow up.
Phase
N
Mean
Standart deviation
Quality of life_before fracture
82
5.74
1.38
Quality of life_14 days after the fracture
82
10.67
2.78
Quality of life_before fracture
82
5.74
1.38
Quality of life_4 month after the fracture
82
8.98
1.85
Quality of life_before fracture
82
5.74
1.38
Quality of life_12 month after the fracture
82
8.28
2.03
t
p-value
-18.222
0.000*
-15.952
0.000*
-12.762
0.000*
*p<0.05
Health status before vertebral fracture was 75.15 ± 10.67 points and after 12 month – 63.33±12.52 points (p <0.001). Before the fracture 69 (84.1 %) subjects were mobile, 77 (93.9 %) of them were able to look after themself, and 66 (80.5 %) - to engage in normal activities without problems. After 12 months the mobility decreased to 46.3 % and only 41 (50.0 %) subjects were able to look after themselves without problems. Before the
fracture 71 (86.6 %) subjects did not feel any back pain, and only 8 persons (9,8 %) did not feel back pain 12 months after vertebral fracture (p <0.01). 14 (17.1 %) respondents felt anxious before fracture and followed by 12 months 40 (48.8 %) felt anxiety (p <0.001).
Fig.1 The frequency of those reporting moderate or severe problems in the five dimensions of EQ5D at the follow-up
The number of patients reporting moderate or severe problems
EQ-5D separated into five dementions 82
80
74 66 60
CONCLUSION
58
54 44 41
40
Mobility
The quality of life 12 months after vertebral fracture was worse than before the fracture, especially in self-care, daily activities, back pain.
Self care Usual activities Pain/Discomfort
20
0
Anxiety/Depression
18 14 5 Before fracture
±14 days
12 months
Time
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