Hip fracture outcomes: quality of life and functional status in older adults living in the community

Hall, Sonĵa E.; Williams, Janice A.; Senior, John; Goldswain, Peter; Criddle, R.A.

doi:10.1111/j.1445-5994.2000.tb00833.x

Cited by 121 publications

(69 citation statements)

References 19 publications

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“…To our knowledge, this is the first time that a randomized trial has been set up with OT training as the single intervention. In relation to the often unfavorable long-term effects of a hip fracture demonstrated in previous studies (Hall et al 2000), the relatively simple and restricted contribution by the occupational therapist in our trial thus seems to have paid off in terms of benefit to the patients and their families. Intervention trials concentrating on the effects of the occupational therapist's role in patient care and rehabilitation, if not completely lacking, are certainly difficult to find in the literature.…”

Section: Discussionmentioning

confidence: 94%

“…Studies have shown the selfreported HRQL to be impaired 3 and up to 12 months postoperatively (Borgqvist et al 1992, Johansson et al 1998, Hall et al 2000, Randell et al 2000, van Balen et al 2001, Tidermark et al 2002, van Balen et al 2003, Suriyawongpaisal et al 2003. However, in a relatively recent study in the US, Peterson et al (2002) reported that the patient's physical function, bodily pain, social function, vitality, emotional role, mental health and general health seemed to have recovered 6 months after the fracture.…”

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confidence: 99%

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Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

2006

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BackgroundIt is not known whether postoperative occupational therapy is of value for hip fracture patients. In this randomized trial we evaluated the effects of an individualized, postoperative, occupational training (OT) program on the patient's self-reported health-related quality of life (HRQL) and self-reported abilities to perform activities of daily living (ADL) and instrumental activities of daily living (IADL).Patients and methods 100 eligible patients (aged ≥ 65 years) were randomized 50:50 to an OT or control group (termed the C group: conventional care). The OT group received individualized OT from day 3 or 4 after surgery and until discharge, and also a home visit. The patients answered the Swedish Health-Related Quality of Life questionnaire (SWED-QUAL) and the modified Disability Rating Index (DRI) three times: 3-4 days after surgery, at discharge, and at follow-up after 2 months.Results We found no statistically significant differences between the groups at discharge and at follow-up regarding mean SWED-QUAL scores. However, on comparing each group over time, 2 months after the fracture the OT group had regained their self-reported pre-fracture HRQL status in 10 of 12 SWED-QUAL subscales, and the C group in 6 subscales. Statistically significant differences (p < 0.05) were found between the groups after 2 months regarding self-reported IADL (moving around indoors, performance of light housework, and getting in and out of a car).Interpretation Our findings indicate that the individualized occupational training improved the ability to

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Section: Discussionmentioning

confidence: 94%

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confidence: 99%

Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

2006

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“…Due to their frequency, hip fractures are one of the most challenging public health concerns, often leading to considerable consequences, including disability (2) and premature death (3,4). Ongoing pain and limited physical mobility can severely compromise quality of life (5). Approximately 20% of US Medicare patients die within 6 months of sustaining a hip fracture (6).…”

Section: Introductionmentioning

confidence: 99%

Hip fractures in the United States: 2008 nationwide emergency department sample

Kim

Meehan²,

Blumenfeld

et al. 2012

Arthritis Care & Research

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Objective. To evaluate the recent epidemiology of hip fractures in the US. Methods. We identified hip fracture cases from the 2008 Nationwide Emergency Department Sample, which contains more than 28 million emergency department (ED) records. Results. In 2008, approximately 341,000 (95% confidence interval 323,000 -358,000) patients visited EDs with hip fractures. Of those, 90% were age >60 years. Between ages 60 -85 years, the risk of fracture doubled for every 5-to 6-year increase in age. However, the hip fracture risk increased slowly after age 85 years. The overall trochanteric-to-cervical fracture ratio was nearly 2:1. The risk of trochanteric fracture increased faster with age compared with the risk of cervical fracture. At age 85 years, the rates of trochanteric and cervical fractures (per 100,000) were 1,300 and 700, respectively, among women and 800 and 500, respectively, among men. Conclusion. The slowed growth of hip fracture risk after age 85 years suggests that the eldest old group may have a distinct hip fracture risk. Our study showed that trochanteric fractures were twice as common as cervical fractures. Because trochanteric fractures are more closely related to severe and generalized bone loss than cervical fractures, we hypothesize that the high incidence rate of trochanteric fractures in the US suggests that osteoporosis is a health problem that is linked to hip fracture. In addition to improved safety measures to reduce falls, rigorous preventive treatments of osteoporosis may be needed.

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“…7 Approximately 20% of Medicare patients in the United States die within 6 months of sustaining a hip fracture. 8 Bisphosphonates are a class of drugs known to interfere with osteoclast bone resorption, a fact that has been exploited clinically for the treatment and prevention of osteoporosis for several decades. In oncology, bisphosphonates have traditionally been used in the palliative care of patients with bone metastases.…”

Section: Introductionmentioning

confidence: 99%

Protective effect of bisphosphonates on endometrial cancer incidence in data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial

Alford

Rattan

Buekers

et al. 2014

Cancer

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BACKGROUND: Preclinical studies have demonstrated antitumor effects of bisphosphonates. The objective of the current study was to determine the effect of exposure to bisphosphonate on the incidence of endometrial cancer. METHODS: The authors used data from the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, which collected data on all cancers. In year 5, all participants were asked to complete a self-administered supplemental questionnaire (SQX) that included questions regarding bone medication use. For women without a cancer diagnosis at the time of the SQX, the authors identified whether a woman reported current or former use of a nitrogenous bisphosphonate (NBP), defined as ever-use, and compared them with women never exposed to an NBP. Women with missing information were excluded as were women who reported undergoing a hysterectomy. Incidence rates and rate ratios were calculated with 95% confidence intervals (95% CIs). Cox proportional hazard ratios were also calculated and adjusted for covariates. RESULTS: A total of 29,254 women were included in the current analysis; an additional 77 cases of endometrial cancer have been diagnosed since the SQX. The incidence rate for endometrial cancer among women exposed to NBPs was 8.7 per 10,000 person-years versus 17.7 per 10,000 person-years among never-exposed women (rate ratio, 0.49; 95% CI, 0.30-0.80). The effect was similar after adjusting for all the covariates in the Cox proportional hazards analysis, with a hazard ratio of 0.56 (95% CI, 0.34-0.93). CONCLUSIONS: The results of the current study suggest that use of NBPs may have a protective effect on the incidence of endometrial cancer. However, additional studies are needed that include other potential confounders and a larger sample. Cancer 2015;121:441-7.

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Hip fracture outcomes: quality of life and functional status in older adults living in the community

Abstract: The effects of impaired balance and mobility along with reduced functional and social independence are reflected in the diminished QOL perceived by the fracture group. This indicates that many do not return to their pre-fracture lifestyle.

Cited by 121 publications

References 19 publications

Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

Hip fractures in the United States: 2008 nationwide emergency department sample

Protective effect of bisphosphonates on endometrial cancer incidence in data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial

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