Sex Differences in Recovery of Quality of Life 12 Months Post-fracture in Community-dwelling Older Adults: Analyses of the Australian Arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS)

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2021 Jul 8

PMID 34235548

Citations 5

Authors

J Talevski

K M Sanders

J J Watts

G C Nicholson

E Seeman

S Iuliano

R Prince

L March

T Winzenberg

G Duque

P R Ebeling

F Borgstrom

J A Kanis

A L Stuart

A Beauchamp

S L Brennan-Olsen

Affiliations

Soon will be listed here.

Abstract

Introduction: Mortality is higher in men than that in women following a fragility fracture, but it is unclear whether recovery of patient-reported outcomes such as health-related quality of life (HRQoL) differs between sexes. This study aimed to identify sex differences in HRQoL recovery 12 months post-fracture.

Methods: Data were from the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS). Participants recruited to AusICUROS were adults aged ≥50 years who sustained a fragility fracture. HRQoL was measured using the EQ-5D-3L at three time-points post-fracture: within 2 weeks (including pre-fracture recall) and at 4 and 12 months. Multivariate logistic regression analyses were undertaken, adjusting for confounders including age, education, income, and healthcare utilization post-fracture.

Results: Overall, 695 AusICUROS participants (536 women, 77.1%) were eligible for analysis with fractures at the hip (n = 150), distal forearm (n = 261), vertebrae (n = 61), humerus (n = 52), and other skeletal sites (n = 171). At the time of fracture, men were younger, reported a higher income, and were more likely to be employed, compared with women. For all fracture sites combined, there were no differences between men and women in recovery to pre-fracture HRQoL at 12-month follow-up (adjusted OR = 1.09; 95% CI: 0.75-1.61). When stratified by fracture site, no significant sex differences were seen for hip (OR = 1.02; 95% CI: 0.42-2.52), distal forearm (OR = 1.60; 95% CI: 0.68-3.78), vertebral (OR = 2.28; 95% CI: 0.61-8.48), humeral (OR = 1.62; 95% CI: 0.16-9.99), and other fractures (OR = 1.00; 95% CI: 0.44-2.26).

Conclusion: Community-dwelling men and women who survived the 12 months following fragility fracture had a similar trajectory of HRQoL recovery at any skeletal site.

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References

Strom O, Borgstrom F, Kanis J, Compston J, Cooper C, McCloskey E . Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2012; 6:59-155. DOI: 10.1007/s11657-011-0060-1. View

Kanis J, Oden A, Johnell O, Jonsson B, De Laet C, Dawson A . The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001; 12(5):417-27. DOI: 10.1007/s001980170112. View

Dempster D . Osteoporosis and the burden of osteoporosis-related fractures. Am J Manag Care. 2011; 17 Suppl 6:S164-9. View

Borgstrom F, Karlsson L, Ortsater G, Norton N, Halbout P, Cooper C . Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos. 2020; 15(1):59. PMC: 7166207. DOI: 10.1007/s11657-020-0706-y. View

Pisani P, Renna M, Conversano F, Casciaro E, Di Paola M, Quarta E . Major osteoporotic fragility fractures: Risk factor updates and societal impact. World J Orthop. 2016; 7(3):171-81. PMC: 4794536. DOI: 10.5312/wjo.v7.i3.171. View

Svedbom A, Borgstom F, Hernlund E, Strom O, Alekna V, Bianchi M . Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures-results from the ICUROS. Osteoporos Int. 2017; 29(3):557-566. DOI: 10.1007/s00198-017-4317-4. View

Abimanyi-Ochom J, Watts J, Borgstrom F, Nicholson G, Shore-Lorenti C, Stuart A . Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS). Osteoporos Int. 2015; 26(6):1781-90. PMC: 4468793. DOI: 10.1007/s00198-015-3088-z. View

Bliuc D, Nguyen N, Milch V, Nguyen T, Eisman J, Center J . Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009; 301(5):513-21. DOI: 10.1001/jama.2009.50. View

Cauley J, Hochberg M, Lui L, Palermo L, Ensrud K, Hillier T . Long-term risk of incident vertebral fractures. JAMA. 2008; 298(23):2761-7. DOI: 10.1001/jama.298.23.2761. View

10.

Hannan M, Felson D, Dawson-Hughes B, Tucker K, Cupples L, Wilson P . Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res. 2000; 15(4):710-20. DOI: 10.1359/jbmr.2000.15.4.710. View

11.

Sigurdsson G, Aspelund T, Chang M, Jonsdottir B, Sigurdsson S, Eiriksdottir G . Increasing sex difference in bone strength in old age: The Age, Gene/Environment Susceptibility-Reykjavik study (AGES-REYKJAVIK). Bone. 2006; 39(3):644-51. DOI: 10.1016/j.bone.2006.03.020. View

12.

Curtis E, van der Velde R, Moon R, van den Bergh J, Geusens P, de Vries F . Epidemiology of fractures in the United Kingdom 1988-2012: Variation with age, sex, geography, ethnicity and socioeconomic status. Bone. 2016; 87:19-26. PMC: 4890652. DOI: 10.1016/j.bone.2016.03.006. View

13.

Kanis J, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A . Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int. 2000; 11(8):669-74. DOI: 10.1007/s001980070064. View

14.

van Staa T, Dennison E, Leufkens H, Cooper C . Epidemiology of fractures in England and Wales. Bone. 2001; 29(6):517-22. DOI: 10.1016/s8756-3282(01)00614-7. View

15.

Amarilla-Donoso F, Lopez-Espuela F, Roncero-Martin R, Leal-Hernandez O, Puerto-Parejo L, Aliaga-Vera I . Quality of life in elderly people after a hip fracture: a prospective study. Health Qual Life Outcomes. 2020; 18(1):71. PMC: 7071575. DOI: 10.1186/s12955-020-01314-2. View

16.

Sylliaas H, Thingstad P, Wyller T, Helbostad J, Sletvold O, Bergland A . Prognostic factors for self-rated function and perceived health in patient living at home three months after a hip fracture. Disabil Rehabil. 2012; 34(14):1225-31. DOI: 10.3109/09638288.2011.643333. View

17.

Van Son M, de Vries J, Zijlstra W, Roukema J, Gosens T, Verhofstad M . Trajectories in quality of life of patients with a fracture of the distal radius or ankle using latent class analysis. Qual Life Res. 2017; 26(12):3251-3265. PMC: 5681973. DOI: 10.1007/s11136-017-1670-x. View

18.

Adachi J, Loannidis G, Berger C, Joseph L, Papaioannou A, Pickard L . The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporos Int. 2002; 12(11):903-8. DOI: 10.1007/s001980170017. View

19.

Papaioannou A, Kennedy C, Ioannidis G, Sawka A, Hopman W, Pickard L . The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study. Osteoporos Int. 2008; 20(5):703-14. PMC: 5101052. DOI: 10.1007/s00198-008-0743-7. View

20.

Mizrahi E, Arad M, Fleissig Y, Adunsky A . Gender differences in functional outcome of elderly hip fracture patients. Geriatr Gerontol Int. 2013; 14(4):845-50. DOI: 10.1111/ggi.12178. View