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髋部骨折后的生活质量:一项为期12个月的前瞻性研究。

Quality of life after hip fracture: a 12-month prospective study.

作者信息

Amarilla-Donoso Francisco Javier, Roncero-Martin Raul, Lavado-Garcia Jesus Maria, Toribio-Felipe Rosaura, Moran-Garcia Jose Maria, Lopez-Espuela Fidel

机构信息

Department of Nursing, Hospital Campo Arañuelo de Navalmoral de la Mata, Navalmoral de la Mata, Spain.

Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain.

出版信息

PeerJ. 2020 Jun 16;8:e9215. doi: 10.7717/peerj.9215. eCollection 2020.

Abstract

BACKGROUND

Hip fracture is an important and frequent health problem worldwide. To date, there are still limited studies focused on the analysis of health-related quality of life (HRQOL) after a hip fracture in the Spanish population, especially with long-term follow-up.

OBJECTIVE

To determine the HRQOL at 12 months after hip fracture and to identify potential factors associated with HRQOL.

DESIGN

Prospective observational study.

SETTING

Traumatology units of two university hospitals in province Cáceres (Spain).

PARTICIPANTS

A total of 224 patients were admitted to the unit and required immediate surgery due to a hip fracture.

METHODS

HRQOL was measured with the EuroQol-5D questionnaire (EQ-5D) and the SF-12 Health Survey.

RESULTS

Scores from the visual analog scale EQ-5D decreased significantly ( < 0.001) from 72.8 at baseline to 48.3 after 1 month, to 48.2 after 6 months and to 46.1 after 12 months. The EQ-5D index score showed a similar significant reduction ( < 0.001) from 0.6 to 0.1, 0.3 and 0.3, respectively. Values of the physical component summary (PCS-12) significantly decreased ( < 0.001) from 38.6 at baseline to 31.0, 33.1 and 33.5. The mental component summary (MCS-12) decreased from 46.5 to 44.8 after 6 months ( = 0.022) and 44.3 after 12 months ( = 0.005). Factors potentially associated with HRQOL at 12 months after hip fracture were depression status after 12 months ( = 0-1.876; 95% CI [-2.409 to -1.343]; < 0.001), functional ambulation classification after 12 months (B = -12.133; 95% CI [-17.970 to -6.297]; < 0.001), EQ-5D VAS at baseline ( = 0.223; 95% CI [0.115-0.330]; < 0.001), and age ( = -0.323; 95% CI [-0.594 to -0.053; = 0.015).

CONCLUSIONS

Patients experience a significant impairment in HRQOL H after a hip fracture, especially in self-care, pain/discomfort, usual activities, mobility and anxiety/depression. The decline in the HRQOL is effective the first month and lasts at least 12 months after the surgical intervention.

摘要

背景

髋部骨折是全球范围内一个重要且常见的健康问题。迄今为止,针对西班牙人群髋部骨折后健康相关生活质量(HRQOL)分析的研究仍然有限,尤其是长期随访的研究。

目的

确定髋部骨折后12个月时的HRQOL,并识别与HRQOL相关的潜在因素。

设计

前瞻性观察性研究。

地点

西班牙卡塞雷斯省两家大学医院的创伤科。

参与者

共有224例因髋部骨折入院并需要立即手术的患者。

方法

使用欧洲五维健康量表(EQ-5D)问卷和SF-12健康调查来测量HRQOL。

结果

视觉模拟量表EQ-5D的得分从基线时的72.8显著下降(P<0.001),1个月后降至48.3,6个月后降至48.2,12个月后降至46.1。EQ-5D指数得分也有类似的显著下降(P<0.001),分别从0.6降至0.1、0.3和0.3。身体成分汇总得分(PCS-12)从基线时的38.6显著下降(P<0.001)至31.0、33.1和33.5。精神成分汇总得分(MCS-12)在6个月后从46.5降至44.8(P = 0.022),12个月后降至44.3(P = 0.005)。髋部骨折后12个月时与HRQOL潜在相关的因素包括12个月后的抑郁状态(β = -1.876;95%置信区间[-2.409至-1.343];P<0.001)、12个月后的功能步行分类(B = -12.133;95%置信区间[-17.970至-6.297];P<0.001)、基线时的EQ-5D视觉模拟量表得分(β = 0.223;95%置信区间[0.115 - 0.330];P<0.001)以及年龄(β = -0.323;95%置信区间[-0.594至-0.053];P = 0.015)。

结论

髋部骨折后患者的HRQOL会出现显著损害,尤其是在自我护理、疼痛/不适、日常活动、行动能力和焦虑/抑郁方面。HRQOL的下降在术后第一个月就很明显,并且在手术干预后至少持续12个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dc7/7304420/873dd8c8daaf/peerj-08-9215-g001.jpg

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