School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori, 683-8503, Japan.
Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan.
Osteoporos Int. 2022 Jul;33(7):1445-1455. doi: 10.1007/s00198-021-06279-6. Epub 2022 Feb 23.
We examined the effects of the coordinator-based intervention on quality of life (QOL) in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL. The coordinator-based interventions mitigated the decrease in QOL. Secondary fracture after primary fracture, however, was a significant predictor of lower QOL.
This study aimed to determine the effects of the coordinator-based intervention on QOL in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL, in an Asian population.
Patients with new fractures in the intervention group received the coordinator-based intervention by a designated nurse certified as a coordinator, within 3 months of injury. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L) scale before the fracture (through patient recollections) and at 0.5, 1, and 2 years after the primary fracture.
Data for 141 patients were analyzed: 70 in the liaison intervention (LI) group and 71 in the non-LI group. Significant intervention effects on QOL were observed at 6 months after the fracture; the QOL score was 0.079 points higher in the LI group than in the non-LI group (p=0.019). Further, the LI group reported significantly less pain/discomfort at 2 years after the fracture, compared to the non-LI group (p=0.037). In addition, secondary fractures were found to significantly prevent improvement and maintenance of QOL during the recovery period (p=0.015).
Short-term intervention effects were observable 6 months after the primary fracture, with the LI group mitigated the decrease in QOL. Few patients in the LI group reported pain/discomfort 2 years after the fracture, but there is uncertainty regarding its clinical significance. Secondary fracture after initial injury was a significant predictor of lower QOL after a fracture.
本研究旨在确定在亚洲人群中，协调员干预对脆性骨折后生活质量（QOL）的影响，以及预测骨折后 QOL 的因素。
干预组的新骨折患者在受伤后 3 个月内由经过认证的协调员护士接受协调员干预。骨折前（通过患者回忆）和原发性骨折后 0.5、1 和 2 年使用欧洲五维健康量表 5 维度 5 水平量表（EQ-5D-5L）的日本版评估 QOL。
共分析了 141 名患者的数据：70 名患者接受联络干预（LI），71 名患者未接受 LI。骨折后 6 个月时观察到 QOL 有显著的干预效果；LI 组的 QOL 评分比非 LI 组高 0.079 分（p=0.019）。此外，LI 组在骨折后 2 年时报告的疼痛/不适明显少于非 LI 组（p=0.037）。此外，二次骨折被发现显著阻碍了恢复期 QOL 的改善和维持（p=0.015）。
原发性骨折后 6 个月可观察到短期干预效果，LI 组可减轻 QOL 的下降。LI 组中有少数患者在骨折后 2 年报告有疼痛/不适，但不确定其临床意义。初次损伤后的二次骨折是骨折后 QOL 降低的一个显著预测因素。
