van Schoor N M, Ewing S K, O'Neill T W, Lunt M, Smit J H, Lips P
EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Qual Life Res. 2008 Feb;17(1):159-67. doi: 10.1007/s11136-007-9287-0. Epub 2007 Nov 27.
Data are scarce on the impact of vertebral fractures (VFX) on utility. The objective of this study was to assess the impact of prevalent and incident VFX on utility in both a patient-based and population-based sample. Data from the Multiple Outcomes of Raloxifene Evaluation (MORE) study (n = 550 for prevalent VFX and n = 174 for incident VFX) and the European Prospective Osteoporosis Study (EPOS) (n = 236) were used. Utility was assessed by the index score of the EQ-5D. In the MORE study, highly statistically significant associations were found between utility and the presence of prevalent VFX (p < 0.001), number of prevalent VFX (p < 0.001), severity of prevalent VFX (p < 0.001), the combination of number and severity of prevalent VFX (p = 0.001) and location of prevalent VFX (p = 0.019). The mean utility was significantly lower among women who suffered an incident VFX (utility = 0.67) than among women who did not (utility = 0.77) (p = 0.005), although utility loss was not significantly different between the two groups (p = 0.142). In EPOS, the combination of number and severity of incident VFX was significantly related to utility (p = 0.030). In conclusion, utility is lower among persons with prevalent and incident VFX, especially in a patient-based sample. Utility loss was not significantly different between women without and with incident VFX.
关于椎体骨折(VFX)对效用影响的数据很少。本研究的目的是在基于患者和基于人群的样本中评估现患和新发VFX对效用的影响。使用了雷洛昔芬评估多项结果(MORE)研究的数据(现患VFX组n = 550,新发VFX组n = 174)以及欧洲骨质疏松前瞻性研究(EPOS)的数据(n = 236)。效用通过EQ - 5D的指数得分进行评估。在MORE研究中,发现效用与现患VFX的存在(p < 0.001)、现患VFX的数量(p < 0.001)、现患VFX的严重程度(p < 0.001)、现患VFX数量和严重程度的组合(p = 0.001)以及现患VFX的位置(p = 0.019)之间存在高度统计学显著关联。发生新发VFX的女性的平均效用(效用 = 0.67)显著低于未发生新发VFX的女性(效用 = 0.77)(p = 0.005),尽管两组之间的效用损失无显著差异(p = 0.142)。在EPOS中,新发VFX数量和严重程度的组合与效用显著相关(p = 0.030)。总之,现患和新发VFX患者的效用较低,尤其是在基于患者的样本中。未发生和发生新发VFX的女性之间的效用损失无显著差异。