Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures—results from the ICUROS

Svedbom, Axel; Borgstöm, Fredrik; Hernlund, E; Ström, O.; Alekna, Vidmantas; Bianchi, Maria Luisa; Clark, Patricia; Curiel, Manuel Dı́az; Dimai, Hans Peter; Jürisson, Mikk; Kallikorm, Riina; Lember, Margus; Lesnyak, Olga; McCloskey, Eugène; Sanders, Kerrie M.; Silverman, Stuart L.; Solodovnikov, Alexander; Tamulaitienė, Marija; Thomas, Thierry; Торопцова, Н. В.; Uusküla, Anneli; Tosteson, Anna N.A.; Jönsson, Bengt; Kanis, John А.

doi:10.1007/s00198-017-4317-4

Cited by 104 publications

(77 citation statements)

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“…QALYs lost due to fragility fractures were estimated from fracture-based HRQoL, fracture risks and death rates [40][41][42]. Methods are summarised in the Appendix (8: Qualityadjusted life years).…”

Section: Quality-adjusted Life Yearsmentioning

confidence: 99%

“…To measure this loss of productivity, data collected in the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) [41,45,46] were used to estimate the number of sick days taken by nonretired individuals from the ages of 50 to 65 years in the year following an osteoporotic fracture. Since Germany was not included in the 11 countries that made up the ICUROS study, a combination of the other 5 countries, as well as Austria and Estonia, termed ICUROS Europe, was used as a substitute measure for the EU6.…”

Section: Loss Of Productivitymentioning

confidence: 99%

“…Continued care provided at home can put physical, emotional and financial strain on relatives who need to take care of osteoporotic fracture patients [15,47]. To measure the average burden placed on informal caregivers per year, survey responses from the ICUROS [41,45,46] were also used to determine the caregiver burden due to osteoporotic fracture. It was measured in terms of hours of care per year provided by relatives of fracture cases in ICUROS Europe (a substitute measure for the EU6), as well as selected countries.…”

Section: Caregiver Burdenmentioning

confidence: 99%

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Fragility fractures in Europe: burden, management and opportunities

et al. 2020

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This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five countries of the European Union plus Sweden (EU6). In 2017, new fragility fractures in the EU6 are estimated at 2.7 million with an associated annual cost of €37.5 billion and a loss of 1.0 million quality-adjusted life years. Introduction Osteoporosis is characterized by reduced bone mass and strength, which increases the risk of fragility fractures, which in turn, represent the main consequence of the disease. This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five EU countries and Sweden (designated the EU6). Methods A series of metrics describing the burden and management of fragility fractures were defined by a scientific steering committee. A working group performed the data collection and analysis. Data were collected from current literature, available retrospective data and public sources. Different methods were applied (e.g. standard statistics and health economic modelling), where appropriate, to perform the analysis for each metric. Results Total fragility fractures in the EU6 are estimated to increase from 2.7 million in 2017 to 3.3 million in 2030; a 23% increase. The resulting annual fracture-related costs (€37.5 billion in 2017) are expected to increase by 27%. An estimated 1.0 million quality-adjusted life years (QALYs) were lost in 2017 due to fragility fractures. The current disability-adjusted life years (DALYs) per 1000 individuals age 50 years or more were estimated at 21 years, which is higher than the estimates for stroke or chronic obstructive pulmonary disease. The treatment gap (percentage of eligible individuals not receiving treatment with osteoporosis drugs) in the EU6 is estimated to be 73% for women and 63% for men; an increase of 17% since 2010. If all patients who fracture in the EU6 were enrolled into fracture liaison services, at least 19,000 fractures every year might be avoided. Conclusions Fracture-related burden is expected to increase over the coming decades. Given the substantial treatment gap and proven cost-effectiveness of fracture prevention schemes such as fracture liaison services, urgent action is needed to ensure that all individuals at high risk of fragility fracture are appropriately assessed and treated.

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Section: Quality-adjusted Life Yearsmentioning

confidence: 99%

Section: Loss Of Productivitymentioning

confidence: 99%

Section: Caregiver Burdenmentioning

confidence: 99%

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Fragility fractures in Europe: burden, management and opportunities

et al. 2020

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“…To overcome these issues and to estimate the costs and quality of life related to fractures in a number of countries across the world, the International Osteoporosis Foundation initiated the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) in 2007. Results of the ICUROS [8,9] showed that fragility hip, vertebral, and distal forearm fractures resulted in substantial QoL loss directly after fracture. While QoL improved with time, 18 months after fracture, mean health state utility values (HSUVs) were lower than before the fracture in patients with hip fracture (0.66 vs. 0.77 p < 0.001) and vertebral fracture (0.70 vs.0.83 p < 0.001) [8].…”

Section: Introductionmentioning

confidence: 99%

Quality of life after fragility fracture in the Russian Federation: results from the Russian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (ICUROS)

Lesnyak

Svedbom²,

Belova

et al. 2020

Arch Osteoporos

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Changes in health-related quality of life (QoL) due to hip, humeral, ankle, spine, and distal forearm fracture were measured in Russian adults age 50 years or more over the first 18 months after fracture. The accumulated mean QoL loss after hip fracture was 0.5 and significantly greater than after fracture of the distal forearm (0.13), spine (0.21), proximal humerus (0.26), and ankle (0.27). Introduction Data on QoL following osteoporotic fractures in Russia are scarce. The present study evaluated the impact of hip, vertebral, proximal humerus, distal forearm, and ankle fracture up to 18 months after fracture from the Russian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study. Methods Individuals age ≥ 50 years with low-energy-induced humeral, hip, clinical vertebral, ankle, or distal forearm fracture were enrolled. After a recall of pre-fracture status, HRQoL was prospectively collected over 18 months of follow-up using EQ-5D-3L. Multivariate regression analysis was used to identify determinants of QALYs loss.

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“…(3)(4)(5) An accurate assessment of HRQL is essential for both economic modeling and policy making. Although many studies have examined HRQL of individuals with osteoporosis and fractures, aiming to determine the utility weights associated with different types of fractures (6)(7)(8)(9)(10)(11) or the association between utility loss, prior fracture, and hospitalization across different countries, (12) little research has explored the impact of single and multiple fragility fractures over a prolonged period of time (10 years or more). A study that examined utility loss over the longest time frame was published by Papaioannou and colleagues.…”

Section: Introductionmentioning

confidence: 99%

Incident Fragility Fractures Have a Long-Term Negative Impact on Health-Related Quality of Life of Older People: The Canadian Multicentre Osteoporosis Study

Borhan

Παπαϊωάννου

Gajić-Veljanoski

et al. 2019

Journal of Bone and Mineral Research

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Although the short‐term impact of incident fragility fractures on health‐related quality of life (HRQL) of older people has been confirmed, we lack long‐term evidence. We explored the impact of incident fragility fractures on HRQL, among people aged 50 years and older, using 10‐year prospective data from the Canadian Multicentre Osteoporosis Study (CaMos). This study was based on data from 7753 (2187 men and 5566 women) participants of CaMos. The HRQL, measured through the Health Utility Index (HUI), was captured at baseline and year 10. The incident fragility fractures were recorded over 10 years of follow‐up at spine, hip, rib, shoulder, pelvis, or forearm. Multivariable regression analysis was conducted to measure the mean difference, termed as deficit, in the HUI scores for participants with and without fractures. We examined the effects of single or multiple fragility fractures, time (fractures that occurred between year 1 to 5 and 6 to 10) and recovery to the prefracture level. Incident spine and hip fractures were associated with significant deficits (varied from –0.19 to –0.07) on the HUI scores. Hip and spine fractures were associated with negative impact on mobility, self‐care, and ambulation. Fractures that occurred closer to the follow‐up assessment were associated with significant impact on HRQL compared to fractures occurring a long time before it, except for hip fracture (deficits lasted 5 years or longer). Similarly, multiple hip (–0.14), spine (–0.16), and rib (–0.21) fractures significantly impacted the HRQL of women. Women with a hip fracture never recovered to their prefracture level score (OR = 0.41; 95% confidence interval [CI], 0.19 to 0.98). Our analysis suggests that single and multiple hip fractures as well as multiple spine and rib fractures strongly impact the HRQL of older people over a prolonged period of time. © 2019 American Society for Bone and Mineral Research.

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Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures—results from the ICUROS

Abstract: Hip, vertebral, and distal forearm fractures incur substantial loss in QoL and for patients with hip or vertebral fracture, QoL is markedly impaired for at least 18 months.

Cited by 104 publications

References 28 publications

Fragility fractures in Europe: burden, management and opportunities

Fragility fractures in Europe: burden, management and opportunities

Quality of life after fragility fracture in the Russian Federation: results from the Russian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (ICUROS)

Incident Fragility Fractures Have a Long-Term Negative Impact on Health-Related Quality of Life of Older People: The Canadian Multicentre Osteoporosis Study

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