ABSTRACT
PURPOSE: The medical morbidity and mortality associated with neck of femur fractures is well-documented, whereas there is limited data for patient-reported outcomes. The aim of this study was to characterize the impact of neck of femur fractures on activities of daily living and patient-reported health-related quality of life. METHODS: Design and participants: Multicentric prospective cohort study. Consecutive sample patients with fragility hip fracture over 50 years old admitted in 48 hospitals in Spain. OUTCOMES: daily living activity function (Barthel Index) and health-related quality of life (EQ-5D) pre-fracture, admission to hospital and at 1- and 4-month follow-up post-fracture. STATISTICS: Barthel and EQ-5D over time are described as mean (SD) and median (interquartile range). RESULTS: A total of 997 patients were recruited at baseline with 4-month outcomes available for, and 856 patients (89.5%). Barthel Index fell from 78.77 (23.75) at baseline to 43.62 (19.86) on admission to hospital with the fracture. Scores partially recovered to 54.89 (25.40) and 64.09 (21.35) at 1- and 4-month post-fracture, respectively. EQ-5D fell from a median of 0.75 (0.47-0.91) to - 0.01 (- 0.03 to 0.51) on admission. Partial recovery was observed again to (0.51 (- 0.06 to 0.67)) and (0.60 (0.10 to 0.80)) at 1- and 4-month post-fracture, respectively. CONCLUSIONS: Hip fracture results in a large decline in the ability to perform activities of daily living and patient-reported health-related quality of life with only partial recovery amongst survivors 4-month post-fracture.
Subject(s)
Activities of Daily Living , Femoral Neck Fractures/psychology , Quality of Life , Aged , Aged, 80 and over , Cost of Illness , Female , Femoral Neck Fractures/physiopathology , Humans , Male , Middle Aged , Patient Reported Outcome Measures , Prospective Studies , SpainABSTRACT
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Subject(s)
Female , Humans , Male , Osteoporosis/epidemiology , Osteoporosis/prevention & control , Osteoporotic Fractures/epidemiology , Osteoporotic Fractures/prevention & control , Risk Factors , Densitometry/instrumentation , Densitometry/methods , Vitamin D/therapeutic use , Osteoporosis/diagnosis , Osteoporosis/therapy , Diagnosis, Differential , Osteoporotic Fractures , Orthopedics/methods , Glucocorticoids/therapeutic use , AlgorithmsSubject(s)
Osteoporosis , Osteoporotic Fractures , Absorptiometry, Photon , Algorithms , Bone Density Conservation Agents/therapeutic use , Clinical Decision-Making , Combined Modality Therapy , Decision Support Techniques , Female , Fracture Fixation/methods , Health Status Indicators , Hip Fractures/diagnosis , Hip Fractures/etiology , Hip Fractures/therapy , Humans , Male , Osteoporosis/complications , Osteoporosis/diagnosis , Osteoporosis/therapy , Osteoporotic Fractures/diagnosis , Osteoporotic Fractures/epidemiology , Osteoporotic Fractures/etiology , Osteoporotic Fractures/therapy , Risk Assessment , Risk Factors , Spain/epidemiology , Spinal Fractures/diagnosis , Spinal Fractures/etiology , Spinal Fractures/therapy , Tomography, X-Ray Computed , Vitamin D/therapeutic use , Vitamins/therapeutic useABSTRACT
Hoy en día se considera que la resistencia ósea, entendiendo como tal la fuerza necesaria para desencadenar el fracaso biomecánico de un hueso, es el resultado de la integración de dos variables, la cantidad y la calidad ósea, factores dependientes a su vez del remodelado óseo. Mientras la cantidad de hueso depende directamente de su densidad mineral, la calidad del mismo depende de variables tales como la estructuración jerárquica y la composición química del material que lo forma. Cada uno de estos determinantes primarios de la resistencia ósea comprende a su vez una serie de determinantes secundarios, responsables directos de alguna de las propiedades biomecánicas óseas específicas. En conjunto, determinantes primarios y secundarios ayudan a establecer un hueso sano, resistente y biomecánicamente competente, mientras que sus alteraciones son responsables del desarrollo de osteopatías fragilizantes, procesos fisiopatológicos que incrementan el riesgo de fractura
Nowadays it is considered that bone strength, understanding as so the necessary load to cause a biomechanical failure of bone, it is the result of the integration of two variables, bone mass and bone quality, both related with bone remodelling. While bone mass depends directly on its mineral density, quality of bone depends on variables such as the hierarchic structure and chemical composition of its material. Each one of these bone strength primary determinants include a serial of secondary ones related with some of the specific biomechanical properties of bone. Altogether, primary and secondary determinants, help to establish a healthy, resistant and mechanical competent bone, whereas their alterations produce weakening osteopathies that increase fracture risk
