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Quality of life after hip fracture: a 12-month prospective study

髋部骨折后的生活质量: 一项为期 12 个月的前瞻性研究

  • 影响因子:2.50
  • DOI:10.7717/peerj.9215
  • 作者列表:"Francisco Javier Amarilla-Donoso","Raul Roncero-Martin","Jesus Maria Lavado-Garcia","Rosaura Toribio-Felipe","Jose Maria Moran-Garcia","Fidel Lopez-Espuela
  • 发表时间:2020-06-19
Abstract

Background Hip fracture is an important and frequent health problem worldwide. To date, there are still limited studies focused on the analysis of health-related quality of life (HRQOL) after a hip fracture in the Spanish population, especially with long-term follow-up. Objective To determine the HRQOL at 12 months after hip fracture and to identify potential factors associated with HRQOL. Design Prospective observational study. Setting Traumatology units of two university hospitals in province Cáceres (Spain). Participants A total of 224 patients were admitted to the unit and required immediate surgery due to a hip fracture. Methods HRQOL was measured with the EuroQol-5D questionnaire (EQ-5D) and the SF-12 Health Survey. Results Scores from the visual analog scale EQ-5D decreased significantly (p < 0.001) from 72.8 at baseline to 48.3 after 1 month, to 48.2 after 6 months and to 46.1 after 12 months. The EQ-5D index score showed a similar significant reduction (p < 0.001) from 0.6 to 0.1, 0.3 and 0.3, respectively. Values of the physical component summary (PCS-12) significantly decreased (p < 0.001) from 38.6 at baseline to 31.0, 33.1 and 33.5. The mental component summary (MCS-12) decreased from 46.5 to 44.8 after 6 months (p = 0.022) and 44.3 after 12 months (p = 0.005). Factors potentially associated with HRQOL at 12 months after hip fracture were depression status after 12 months (B = 0–1.876; 95% CI [−2.409 to −1.343]; p < 0.001), functional ambulation classification after 12 months (B = −12.133; 95% CI [−17.970 to −6.297]; p < 0.001), EQ-5D VAS at baseline (B = 0.223; 95% CI [0.115–0.330]; p < 0.001), and age (B = −0.323; 95% CI [−0.594 to −0.053; p = 0.015). Conclusions Patients experience a significant impairment in HRQOL H after a hip fracture, especially in self-care, pain/discomfort, usual activities, mobility and anxiety/depression. The decline in the HRQOL is effective the first month and lasts at least 12 months after the surgical intervention.

摘要

背景髋部骨折是世界范围内重要且常见的健康问题。迄今为止,仍有有限的研究集中在分析西班牙人群髋部骨折后的健康相关生活质量 (HRQOL),特别是长期随访。目的确定髋部骨折后 12 个月的 HRQOL,并确定与 HRQOL 相关的潜在因素。设计前瞻性观察性研究。设置 c á ceres 省 (西班牙) 两所大学医院的创伤学单位。参与者共有 224 名患者入住该病房,因髋部骨折需要立即手术。方法采用 EuroQol-5D 问卷 (EQ-5D) 和 SF-12 健康调查相结合的方法进行 HRQOL 测量。结果 EQ-5D 的视觉模拟评分从基线的 0.001 显著下降 (p <72.8) 到 1 个月后的 48.3,6 个月后的 48.2 和 12 个月后的 46.1。EQ-5D 指数评分分别从 0.001 降至 0.6 、 0.1 和 0.3,差异有统计学意义 (p <0.3)。物理成分汇总 (PCS-12) 值显著下降 (p <0.001),从基线时的 38.6 降至 31.0 、 33.1 和 33.5。6 个月后精神成分汇总 (MCS-12) 从 46.5 下降到 44.8 (p = 0.022),12 个月后从 44.3 (p = 0.005)。髋部骨折后 12 个月时与 HRQOL 潜在相关的因素为 12 个月后的抑郁状态 (B = 0-1.876; 95% CI [-2.409 ~-1.343]; p <0.001),12 个月后功能性步行分级 (B =-12.133; 95% CI [-17.970 ~-6.297]; p <0.001),EQ-5D 基线 VAS(B = 0.223; 95% CI [0.115-0.330]; p < 0.001) 和年龄 (B =-0.323; 95% CI [-0.594 ~-0.053; p = 0.015)。结论髋部骨折后 24 H HRQOL 明显受损,尤其是自我护理、疼痛/不适、日常活动、活动能力和焦虑/抑郁。HRQOL 的下降在手术干预后的第一个月有效,至少持续 12 个月。

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