HEALTH RELATED QUALITY OF LIFE 12 MONTHSAFTER VERTEBRAL FRACTURE

Violeta Sinkevičienė1,2, Vidmantas Alekna1,2, Danutė Kalibatienė1, Marija Tamulaitienė1,2

1 Vilnius University Faculty of Medicine, 2 National Osteoporosis Center

STUDY OBJECTIVESTo assess health-related quality of life 12 months after vertebral fracture.

CONCLUSIONThe quality of life 12 months after vertebral fracture was worse than before the fracture, especially in self-care, daily activities, back pain.

INTRODUCTIONThe vertebral body fracture is the most frequent type of osteoporotic fracture [1]. Os-

teoporosis and associated fractures are a major public health concern because of related morbidity and disability, decreased quality of life and mortality [2]. Vertebral fractures are the hallmark of osteoporosis, it may be minor and pass unnoticed, or they may lead

to long-term immobility and disability [3]. It is well known and frequently reported that the vertebral body fracture causes pain, disability and has a negative effect on the patient’s health-related quality of life [4].

METHODS AND MATERIALSSubjects aged 50 years and more who sustained vertebral fracture confirmed by x-ray

were included in this study. Within 14 days after the visit to the hospital emergency unit or outpatient department, all eligible patients received written information about the study and invitation to participate. The patients who agreed to participate were asked to answer the questionnaire. The EQ-5D questionnaire was used to evaluate daily living

activities, mobility, self care, usual activities, pain/discomfort, and anxiety/depression. Subjects were investigated two times: interviewed at the hospital, immediately after the fracture and 12 months after the fracture - by phone. Statistical analysis was performed using SPSS software version 18.0 for Windows.

Health status before vertebral fracture was 75.15 ± 10.67 points and after 12 month – 63.33±12.52 points (p <0.001). Before the fracture 69 (84.1 %) subjects were mobile, 77 (93.9 %) of them were able to look after themself, and 66 (80.5 %) - to engage in normal activities without problems. After 12 months the mobility decreased to 46.3 % and only 41 (50.0 %) subjects were able to look after themselves without problems. Before the

fracture 71 (86.6 %) subjects did not feel any back pain, and only 8 persons (9,8 %) did not feel back pain 12 months after vertebral fracture (p <0.01). 14 (17.1 %) respond-ents felt anxious before fracture and followed by 12 months 40 (48.8 %) felt anxiety (p <0.001).

RESULTSA total of 82 persons with average age of 66.54 ± 10.57 years were included in this study: 63 (76.8 %) women and 19 (23.2 %) men. The average of the quality of life before the

fracture was of 5.74 ± 1.38 points and after 12 months - 8.28 ± 2.03 points, as assessed by EQ-5D questionnaire (p <0.01).

REFERENCES:1. Cauley JA, Hochberg MC, Lui LY, Palermo L, Ensrud KE, Hillier TA et al (2007) Long-term risk of incident vertebral fractures. JAMA 298:2761–2767. doi:10.1001/jama.298.23.27612. Rostom S, Allali F, Bennani L, Abouqal R, Hajjaj-Hassouni N. (2012) The prevalence of vertebral fractures and health-related quality of life in postmenopausal women. Rheumatol Int

(2012) 32:971–980 doi 10.1007/s00296-010-1734-53. Lips P, Cooper C, Agnusdei D, Caulin F, Egger P et al (1999) Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Founda-

tion for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporos Int 10(2):150–1604. Salaffi F, Cimmino MA, Malavolta N, Carotti M, Di Matteo L, Scendoni P et al (2007) The burden of prevalent fractures on health-related quality of life in postmenopausal women with

osteoporosis: the IMOF study. J Rheumatol 34:1551–1560

Table 1. The average of the quality of life before the fracture and at the 12 months follow up.

*p<0.05

Phase N Mean Standart deviation t p-value

Quality of life_before fracture 82 5.74 1.38-18.222 0.000*

Quality of life_14 days after the fracture 82 10.67 2.78

Quality of life_before fracture 82 5.74 1.38-15.952 0.000*

Quality of life_4 month after the fracture 82 8.98 1.85

Quality of life_before fracture 82 5.74 1.38-12.762 0.000*

Quality of life_12 month after the fracture 82 8.28 2.03

*Contact address: vidmantas.alekna@osteo.lt

Fig.1 The frequency of those reporting moderate or severe problems in the five dimensions of EQ-5D at the follow-up

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Before fracture ±14 days 12 months

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EQ-5D separated into five dementions

Mobility

Self care

Usual activities

Pain/Discomfort

Anxiety/Depression

Time