Quality of life in elderly people after a hip fracture: a prospective study

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Abstract

Background

Hip fracture is an important social and medical problem due to its increasing prevalence, the consequences for health and the economic impact on the health care system, but there is no doubt that it also has repercussions on health-related quality of life (HRQoL). Hence the importance of understanding and determining the impact of the condition on everyday life from the perspective of the patient’s physical, emotional and social well-being.

Purpose

To determine the impact of hip fracture on HRQoL of people over the age of 65 1 month after surgery, related factors and the effects on functional ability and mood.

Methods

Prospective observational study conducted in the traumatology units of two university hospitals in the province of Cáceres with consecutive sampling of all patients over the age of 65 admitted for hip fracture surgery during the study period. Sociodemographic and clinical data were recorded at the time of admission and prospectively at the follow-up visit 1 month later. Clinical, social, quality of life (EQ-5D-), basic functional and instrumental capacity (Barthel Index (BI) and Lawton & Brody Scale), and geriatric depression (Yesavage) variables were collected.

Results

The study included 224 patients with a median age of 84.6 years (SD ± 6.1), 76.3% were female. Charlson’s comorbidity was 5.3 (SD ± 1.2). The EQ-5D index decreased from 0.62 (SD ± 0.35) to 0.16 at 1 month follow up (SD ± 0.20) p < 0.001. The mean Visual Analog Scale (VAS) score of EQ-5D decreased from 72.8 (SD ±15.8) to 48.3 (SD ± 17.2) p < 0.001. All dimensions of EQ-5D showed a significant reduction from the time of pre-fracture status to 1 month after surgery. Independent factors associated with HRQoL 1 month after surgery were pre-fracture status Barthel Index score, Lawton and Brody scale, presence of depression, and type of surgery.

Conclusions

After a hip fracture, patients experience considerable deterioration in their HRQoL, especially in self-care, daily activities, and mobility. There is also a significant decline in functional capacity for both the basic and instrumental activities of daily living. One month after surgery, HRQoL is a long way from pre-fracture levels.

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Most cited references 35

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Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009

Ray Marks (2010)

Hip fractures – which commonly lead to premature death, high rates of morbidity, or reduced life quality – have been the target of a voluminous amount of research for many years. But has the lifetime risk of incurring a hip fracture decreased sufficiently over the last decade or are high numbers of incident cases continuing to prevail, despite a large body of knowledge and a variety of contemporary preventive and refined surgical approaches? This review examines the extensive hip fracture literature published in the English language between 1980 and 2009 concerning hip fracture prevalence trends, and injury mechanisms. It also highlights the contemporary data concerning the personal and economic impact of the injury, plus potentially remediable risk factors underpinning the injury and ensuing disability. The goal was to examine if there is a continuing need to elucidate upon intervention points that might minimize the risk of incurring a hip fracture and its attendant consequences. Based on this information, it appears hip fractures remain a serious global health issue, despite some declines in the incidence rate of hip fractures among some women. Research also shows widespread regional, ethnic and diagnostic variations in hip fracture incidence trends. Key determinants of hip fractures include age, osteoporosis, and falls, but some determinants such as socioeconomic status, have not been well explored. It is concluded that while more research is needed, well-designed primary, secondary, and tertiary preventive efforts applied in both affluent as well as developing countries are desirable to reduce the present and future burden associated with hip fracture injuries. In this context, and in recognition of the considerable variation in manifestation and distribution, as well as risk factors underpinning hip fractures, well-crafted comprehensive, rather than single solutions, are strongly indicated in early rather than late adulthood.

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Author and article information

Contributors

Francisco Javier Amarilla-Donoso: javier.amarilla@gmail.com

Fidel López-Espuela: fidel.lopez.es@gmail.com

Raúl Roncero-Martín: rronmar@unex.es

Olga Leal-Hernandez: olgaleal@unex.es

Luis Manuel Puerto-Parejo: lmpuerto@unex.es

Ignacio Aliaga-Vera: cuidardelosquecuidan@gmail.com

Rosaura Toribio-Felipe: rotofe@gmail.com

Jesús María Lavado-García: jmlavado@unex.es

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 14 March 2020

Publication date PMC-release: 14 March 2020

Publication date Collection: 2020

Volume: 18

Electronic Location Identifier: 71

Affiliations

[1 ]Department of Nursing, Hospital Campo Arañuelo de Navalmoral de la Mata, Cáceres, Spain

[2 ]GRID grid.8393.1, ISNI 0000000119412521, Nursing Department, Nursing and Occupational Therapy College, , University of Extremadura, ; Avda. De la Universidad S/N. CP: 10003, Caceres, Spain

[3 ]GRID grid.5515.4, ISNI 0000000119578126, Department of Stomatology II, , University of Madrid, Complutense, ; Madrid, Spain

[4 ]GRID grid.413526.7, ISNI 0000 0004 1759 6787, Department of Nursing, , Hospital Virgen del Puerto, Plasencia, ; Plasencia, Spain

Article

Publisher ID: 1314

DOI: 10.1186/s12955-020-01314-2

PMC ID: 7071575

PubMed ID: 32171319

SO-VID: bb2e79d0-400e-4645-8523-7adca36255f0

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 25 September 2018

Date accepted : 3 March 2020

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ScienceOpen disciplines: Health & Social care

Keywords: geriatric care,hip fracture,health-related quality of life

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ScienceOpen disciplines: Health & Social care

Keywords: geriatric care, hip fracture, health-related quality of life

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Quality of life in elderly people after a hip fracture: a prospective study

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Most cited references 35

A physiological profile approach to falls risk assessment and prevention.

Gait assessment for neurologically impaired patients. Standards for outcome assessment.

Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009

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Cited by 34

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