G Valentin1,2, K Friis3, C P Nielsen3, F B Larsen3, B L Langdahl4,5. 1. DEFACTUM, Department of Public Health and Health Services Research, Central Denmark Region, Aarhus, Denmark. Gitte.valentin@rm.dk. 2. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. Gitte.valentin@rm.dk. 3. DEFACTUM, Department of Public Health and Health Services Research, Central Denmark Region, Aarhus, Denmark. 4. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 5. Department of Endocrinology (MEA), Aarhus University Hospital, Aarhus, Denmark.
Abstract
Studying 12,839 fracture cases and 91,426 controls, we found that fractures of the spine and hip are associated with clinically important HRQoL deficits up to 5 years post-fracture. Fracture cases with a low educational attainment are more likely to report very low HRQoL due to a low pre-fracture HRQoL. INTRODUCTION: The aim of this study was to explore the short-term and long-term impact of fractures on health-related quality of life (HRQoL) and to study the effect of educational attainment as a proxy for socio-economic status (SES) on post-fracture HRQoL. METHODS: In a population-based survey including 12,839 fracture cases and 91,426 controls, HRQoL was measured using the physical component score (PCS) and the mental component score (MCS) of the 12-Item Short Form Health Survey (SF-12). Information about fractures, age, sex, ethnicity, comorbidity and SES was obtained from national registers. Multiple regression analysis was conducted to measure the mean HRQoL difference, termed deficit, between non-fracture controls and fracture cases (all fractures combined and fractures at six different skeletal sites). RESULTS: PCS and MCS were significantly lower among fracture cases than among controls. Statistically and clinically important PCS deficits (≥ 5 points) were observed among people with fractures of the spine and hip up to 5 years post-fracture and among people with upper arm fractures up to 1 year post-fracture. Greater deficits were observed for MCS but not for PCS in post-fracture HRQoL in the low than in the high SES group. CONCLUSION: Fractures of the spine and hip are associated with clinically important deficits in physical HRQoL up to 5 years post-fracture. Low educational attainment widened the gap in mental but not in physical post-fracture HRQoL. However, due to low pre-fracture PCS and MCS, people with a low educational attainment and fractures were more likely to report very low HRQoL post-fracture.
Studying 12,839 fracture cases and 91,426 controls, we found that fractures of the spine and hip are associated with clinically important HRQoL deficits up to 5 years post-fracture. Fracture cases with a low educational attainment are more likely to report very low HRQoL due to a low pre-fracture HRQoL. INTRODUCTION: The aim of this study was to explore the short-term and long-term impact of fractures on health-related quality of life (HRQoL) and to study the effect of educational attainment as a proxy for socio-economic status (SES) on post-fracture HRQoL. METHODS: In a population-based survey including 12,839 fracture cases and 91,426 controls, HRQoL was measured using the physical component score (PCS) and the mental component score (MCS) of the 12-Item Short Form Health Survey (SF-12). Information about fractures, age, sex, ethnicity, comorbidity and SES was obtained from national registers. Multiple regression analysis was conducted to measure the mean HRQoL difference, termed deficit, between non-fracture controls and fracture cases (all fractures combined and fractures at six different skeletal sites). RESULTS: PCS and MCS were significantly lower among fracture cases than among controls. Statistically and clinically important PCS deficits (≥ 5 points) were observed among people with fractures of the spine and hip up to 5 years post-fracture and among people with upper arm fractures up to 1 year post-fracture. Greater deficits were observed for MCS but not for PCS in post-fracture HRQoL in the low than in the high SES group. CONCLUSION:Fractures of the spine and hip are associated with clinically important deficits in physical HRQoL up to 5 years post-fracture. Low educational attainment widened the gap in mental but not in physical post-fracture HRQoL. However, due to low pre-fracture PCS and MCS, people with a low educational attainment and fractures were more likely to report very low HRQoL post-fracture.
Entities:
Keywords:
Fractures; Health survey; Health-related quality of life; Inequality; Population-based study; Socio-economic status
Authors: Honghu Liu; Ron D Hays; John L Adams; Wen-Pin Chen; Diana Tisnado; Carol M Mangione; Cheryl L Damberg; Katherine L Kahn Journal: Health Serv Res Date: 2005-06 Impact factor: 3.402
Authors: G Valentin; S E Pedersen; R Christensen; K Friis; C P Nielsen; A Bhimjiyani; C L Gregson; B L Langdahl Journal: Osteoporos Int Date: 2019-08-30 Impact factor: 4.507
Authors: Charles M M Peeters; Eva Visser; Cornelis L P Van de Ree; Taco Gosens; Brenda L Den Oudsten; Jolanda De Vries Journal: Injury Date: 2016-04-23 Impact factor: 2.586
Authors: Anne Illemann Christensen; Ola Ekholm; Charlotte Glümer; Anne Helms Andreasen; Michael Falk Hvidberg; Peter Lund Kristensen; Finn Breinholt Larsen; Britta Ortiz; Knud Juel Journal: Scand J Public Health Date: 2012-06 Impact factor: 3.021
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: E Hernlund; A Svedbom; M Ivergård; J Compston; C Cooper; J Stenmark; E V McCloskey; B Jönsson; J A Kanis Journal: Arch Osteoporos Date: 2013-10-11 Impact factor: 2.617
Authors: Morten Schmidt; Sigrun Alba Johannesdottir Schmidt; Jakob Lynge Sandegaard; Vera Ehrenstein; Lars Pedersen; Henrik Toft Sørensen Journal: Clin Epidemiol Date: 2015-11-17 Impact factor: 4.790
Authors: Brittannia Volkmer; Euan Sadler; Kate Lambe; Finbarr C Martin; Salma Ayis; Lauren Beaupre; Ian D Cameron; Celia L Gregson; Antony Johansen; Morten Tange Kristensen; Jay Magaziner; Catherine Sackley; Toby O Smith; Boris Sobolev; Katie J Sheehan Journal: Age Ageing Date: 2021-11-10 Impact factor: 10.668