Quality of Life in Patients with Osteoporotic Vertebral Compression Fractures

Ho Jin Jung, Ye-Soo Park, Hyoung-Yeon Seo, Jae-Chul Lee, Ki-Chan An, Jin-Hyok Kim, Byung-Joon Shin, Tae Wook Kang, Si Young Park, Ho Jin Jung, Ye-Soo Park, Hyoung-Yeon Seo, Jae-Chul Lee, Ki-Chan An, Jin-Hyok Kim, Byung-Joon Shin, Tae Wook Kang, Si Young Park

Abstract

Background: This study aimed to evaluate quality of life (QOL) using the EuroQOL-5 dimensions (EQ-5D) index and to examine factors affecting QOL in patients with an osteoporotic vertebral compression fracture (OVCF).

Methods: This ambispective study used a questionnaire interview. Patients over 50 years old with an OVCF at least 6 months previously were enrolled. Individual results were used to calculate the EQ-5D index. Statistical analysis was performed, and factors related to QOL were examined.

Results: Of 196 patients in the study, 84.2% were female, with an average age of 72.7 years. There were 66 (33.7%) patients with multilevel fractures. Conservative management was used in 75.0% of patients, and 56.1% received anti-osteoporosis treatment. The mean EQ-5D index was 0.737±0.221 and was significantly correlated with the Oswestry disability index score (correlation coefficient -0.807, P<0.001). The EQ-5D index was significantly correlated with age (Spearman's rho=-2.0, P=0.005), treatment method (P=0.005), and history of fracture (P=0.044) on univariate analysis and with conservative treatment (P<0.001) and osteoporotic treatment (P=0.017) on multivariate analysis.

Conclusions: OVCF markedly lowers QOL in several dimensions for up to 12 months, even in patients who have healed. Treatment of osteoporosis and conservative treatment methods affect QOL and should be considered in OVCF management.

Keywords: Compression fractures; Osteoporosis; Quality of life.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1. Frequency of participant responses according…
Fig. 1. Frequency of participant responses according to European quality of life-5 dimensions (n=196). Sixty-one point seven percentage of patients with osteoporotic vertebral compression fracture had problems with mobility, 54.6% with self-care, 66.7% with usual activities, 80.1% with pain/discomfort, and 40.3% with anxiety/depression.
Fig. 2. European quality of life-5 dimensions…
Fig. 2. European quality of life-5 dimensions (EQ-5D) index and Oswestry disability index (ODI) score showed a strong inverse correlation (Spearman's rho=-0.807, P<0.001).

References

    1. Holroyd C, Cooper C, Dennison E. Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab. 2008;22:671–685.
    1. Choi HJ, Shin CS, Ha YC, et al. Burden of osteoporosis in adults in Korea: a national health insurance database study. J Bone Miner Metab. 2012;30:54–58.
    1. Palacios S, Neyro JL, Fernandez de Cabo S, et al. Impact of osteoporosis and bone fracture on health-related quality of life in postmenopausal women. Climacteric. 2014;17:60–70.
    1. Lee HM, Park SY, Lee SH, et al. Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treatment versus balloon kyphoplasty. Spine J. 2012;12:998–1005.
    1. Shin CS, Kim MJ, Shim SM, et al. The prevalence and risk factors of vertebral fractures in Korea. J Bone Miner Metab. 2012;30:183–192.
    1. Alexandru D, So W. Evaluation and management of vertebral compression fractures. Perm J. 2012;16:46–51.
    1. Cooper C. The crippling consequences of fractures and their impact on quality of life. Am J Med. 1997;103:12S–17S. discussion 17S-19S.
    1. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785–795.
    1. Hubschle L, Borgström F, Olafsson G, et al. Real-life results of balloon kyphoplasty for vertebral compression fractures from the SWISSspine registry. Spine J. 2014;14:2063–2077.
    1. Kim KW, Cho KJ, Kim SW, et al. A nation-wide, outpatient-based survey on the pain, disability, and satisfaction of patients with osteoporotic vertebral compression fractures. Asian Spine J. 2013;7:301–307.
    1. Lee YK, Jang S, Jang S, et al. Mortality after vertebral fracture in Korea: analysis of the National Claim Registry. Osteoporos Int. 2012;23:1859–1865.
    1. Lips P, Cooper C, Agnusdei D, et al. Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporos Int. 1999;10:150–160.
    1. Lips P, van Schoor NM. Quality of life in patients with osteoporosis. Osteoporos Int. 2005;16:447–455.
    1. Suzuki N, Ogikubo O, Hansson T. Previous vertebral compression fractures add to the deterioration of the disability and quality of life after an acute compression fracture. Eur Spine J. 2010;19:567–574.
    1. Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301:513–521.
    1. Silverman SL. The clinical consequences of vertebral compression fracture. Bone. 1992;13(Suppl 2):S27–S31.
    1. Gennari C, Agnusdei D, Camporeale A. Use of calcitonin in the treatment of bone pain associated with osteoporosis. Calcif Tissue Int. 1991;49(Suppl 2):S9–13.
    1. Lyritis GP, Mayasis B, Tsakalakos N, et al. The natural history of the osteoporotic vertebral fracture. Clin Rheumatol. 1989;8(Suppl 2):66–69.
    1. Hall SE, Criddle RA, Comito TL, et al. A case-control study of quality of life and functional impairment in women with long-standing vertebral osteoporotic fracture. Osteoporos Int. 1999;9:508–515.
    1. Hallberg I, Rosenqvist AM, Kartous L, et al. Health-related quality of life after osteoporotic fractures. Osteoporos Int. 2004;15:834–841.
    1. Hasserius R, Karlsson MK, Jónsson B, et al. Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly--a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int. 2005;76:235–242.
    1. O'Neill TW, Cockerill W, Matthis C, et al. Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int. 2004;15:760–765.
    1. Suzuki N, Ogikubo O, Hansson T. The course of the acute vertebral body fragility fracture: its effect on pain, disability and quality of life during 12 months. Eur Spine J. 2008;17:1380–1390.
    1. Al-Sari UA, Tobias J, Clark E. Health-related quality of life in older people with osteoporotic vertebral fractures: a systematic review and meta-analysis. Osteoporos Int. 2016;27:2891–2900.
    1. Lee YK, Nam HS, Chuang LH, et al. South Korean time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. Value Health. 2009;12:1187–1193.
    1. Kim SH, Hwang JS, Kim TW, et al. Validity and reliability of the EQ-5D for cancer patients in Korea. Support Care Cancer. 2012;20:3155–3160.
    1. Räsänen P, Roine E, Sintonen H, et al. Use of quality-adjusted life years for the estimation of effectiveness of health care: a systematic literature review. Int J Technol Assess Health Care. 2006;22:235–241.
    1. Yoon SP, Lee SH, Ki CH, et al. Quality of life in patients with osteoporotic vertebral fractures. Asian Spine J. 2014;8:653–658.
    1. Carreon LY, Bratcher KR, Das N, et al. Estimating EQ-5D values from the Oswestry Disability Index and numeric rating scales for back and leg pain. Spine (Phila Pa 1976) 2014;39:678–682.
    1. Mueller B, Carreon LY, Glassman SD. Comparison of the EuroQOL-5D with the Oswestry Disability Index, back and leg pain scores in patients with degenerative lumbar spine pathology. Spine (Phila Pa 1976) 2013;38:757–761.
    1. Kim MH, Cho YS, Uhm WS, et al. Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases. Qual Life Res. 2005;14:1401–1406.
    1. Lee SI. Validity and reliability evaluation for EQ-5D in Korea. Osong: Korea Centers for Disease Control and Prevention; 2011.
    1. Suzuki N, Ogikubo O, Hansson T. The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation. Eur Spine J. 2009;18:77–88.
    1. Begerow B, Pfeifer M, Pospeschill M, et al. Time since vertebral fracture: an important variable concerning quality of life in patients with postmenopausal osteoporosis. Osteoporos Int. 1999;10:26–33.
    1. Huang C, Ross PD, Wasnich RD. Vertebral fractures and other predictors of back pain among older women. J Bone Miner Res. 1996;11:1026–1032.
    1. Bombardier C. Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine (Phila Pa 1976) 2000;25:3100–3103.
    1. Choi YJ, Lee MS, An SY, et al. The relationship between diabetes mellitus and health-related quality of life in Korean adults: the fourth Korea national health and nutrition examination survey (2007-2009) Diabetes Metab J. 2011;35:587–594.
    1. Kim SH, Oh YM, Jo MW. Health-related quality of life in chronic obstructive pulmonary disease patients in Korea. Health Qual Life Outcomes. 2014;12:57.
    1. Gold DT. The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone. 1996;18:185s–189s.
    1. Kim DY, Lee SH, Lee HY, et al. Validation of the Korean version of the oswestry disability index. Spine (Phila Pa 1976) 2005;30:E123–E127.
    1. Cockerill W, Ismail AA, Cooper C, et al. Does location of vertebral deformity within the spine influence back pain and disability? European Vertebral Osteoporosis Study (EVOS) Group. Ann Rheum Dis. 2000;59:368–371.
    1. Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361:557–568.
    1. Kallmes DF, Comstock BA, Heagerty PJ, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009;361:569–579.
    1. Klazen CA, Lohle PN, de Vries J, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010;376:1085–1092.
    1. Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009;373:1016–1024.
    1. Papanastassiou ID, Phillips FM, Van Meirhaeghe J, et al. Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies. Eur Spine J. 2012;21:1826–1843.
    1. Black DM, Rosen CJ. Clinical practice. Postmenopausal osteoporosis. N Engl J Med. 2016;374:254–262.
    1. Black DM, Cummings SR, Karpf DB, et al. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet. 1996;348:1535–1541.
    1. Chesnut CH, 3rd, Skag A, Christiansen C, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004;19:1241–1249.
    1. Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA. 1998;280:2077–2082.
    1. Harris ST, Watts NB, Genant HK, et al. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA. 1999;282:1344–1352.
    1. Reginster J, Minne HW, Sorensen OH, et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int. 2000;11:83–91.
    1. Madureira MM, Bonfá E, Takayama L, et al. A 12-month randomized controlled trial of balance training in elderly women with osteoporosis: improvement of quality of life. Maturitas. 2010;66:206–211.

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