Mapi Publications

2018. Guirant L et al. – Health-related quality of life during the first year after a hip fracture: Results of the Mexican arm of the International Cost and Utility Related to Osteoporotic Fractures Study (MexICUROS)

 

Guirant L, Carlos F, Curiel D, Kanis JA, Borgström F, Svedbom A, Clark P. Health-related quality of life during the first year after a hip fracture: Results of the Mexican arm of the International Cost and Utility Related to Osteoporotic Fractures Study (MexICUROS). Osteoporos Int. 2018 Feb 20. doi: 10.1007/s00198-018-4389-9. [Epub ahead of print]

https://www.ncbi.nlm.nih.gov/pubmed/29464277

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Abstract

We investigated changes in health-related quality of life (HRQoL) due to hip fracture in Mexican adults aged ≥ 50 years during the first year post-fracture. Mean accumulated loss was 0.27 quality-adjusted life years (QALYs). HRQoL before fracture was the main contributor to explain the loss of QALYs.

INTRODUCTION: We aimed to estimate the health-related quality of life (HRQoL) loss over 1 year in patients sustaining a hip fracture in Mexico.

METHODS: Individuals aged ≥ 50 years old with diagnosis of a low-energy-induced hip fracture enrolled in the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) composed the study population. After a recall of their own pre-fracture status, HRQoL was prospectively collected in three phases over 12 months of follow-up using EQ-5D-3L. The UK preference weight set was applied to calculate the utility values. The accumulated quality-adjusted life years (QALYs) loss in the first year post-fracture was estimated using the trapezoid method. Multivariate regression analysis allowed identifying determinants of QALYs loss.

RESULTS: One hundred ninety-three patients (mean ± SD age 77.2 ± 9.9 years; 80% women; 15.5% with prior fracture in the last 5 years; 78% in low-income category) were evaluated. Mean (95% CI) utility value before fracture was 0.64 (0.59-0.68). It dropped to 0.01 (0.01-0.02) immediately after fracture and then improved to 0.46 (0.42-0.51) and 0.60 (0.55-0.64) at 4 and 12 months post-fracture, respectively. Disregarding fracture-related mortality, accumulated QALYs loss over the first year was 0.27 (0.24-0.30) QALYs. Mobility, self-care, and usual activities were the most affected domains throughout the whole year. HRQoL before fracture was the main contributor to explain the loss of QALYs.

CONCLUSIONS: Hip fractures reduce dramatically the HRQoL, with the loss sustained at least over the first year post-fracture in Mexico. The utility values derived from this study can be used in future economic evaluations.