Sex differences in recovery of quality of life 12 months post-fracture in community-dwelling older adults: analyses of the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS)

doi:10.1007/s00198-021-06058-3

. 2022 Jan;33(1):67-75.

doi: 10.1007/s00198-021-06058-3. Epub 2021 Jul 8.

Sex differences in recovery of quality of life 12 months post-fracture in community-dwelling older adults: analyses of the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS)

J Talevski^{1

2}, K M Sanders^{3

4

5}, J J Watts^{5

6}, G C Nicholson^{3

7}, E Seeman^{8

9}, S Iuliano^{4

8}, R Prince^{10

11}, L March¹², T Winzenberg¹³, G Duque^{3

4}, P R Ebeling¹⁴, F Borgström^{15

16}, J A Kanis^{9

17}, A L Stuart¹⁸, A Beauchamp^{3

4

19}, S L Brennan-Olsen^{3

4

5

6}

Affiliations

¹ Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia. jason.talevski@student.unimelb.edu.au.
² Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia. jason.talevski@student.unimelb.edu.au.
³ Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia.
⁴ Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia.
⁵ School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.
⁶ Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
⁷ Rural Clinical School, The University of Queensland, Toowoomba, Australia.
⁸ Departments of Endocrinology and Medicine, The University of Melbourne/Austin Health, Heidelberg, Victoria, Australia.
⁹ Mary McKillip Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
¹⁰ Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
¹¹ Medical School, Sir Charles Gardner Unit, The University Western Australia, Perth, Western Australia, Australia.
¹² Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.
¹³ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
¹⁴ Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
¹⁵ Quantify Research, Stockholm, Sweden.
¹⁶ Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm, Sweden.
¹⁷ Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
¹⁸ The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine Deakin University, Geelong, Victoria, Australia.
¹⁹ School of Rural Health, Monash University, Victoria, Australia.

PMID: 34235548
DOI: 10.1007/s00198-021-06058-3

Sex differences in recovery of quality of life 12 months post-fracture in community-dwelling older adults: analyses of the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS)

J Talevski et al. Osteoporos Int. 2022 Jan.

. 2022 Jan;33(1):67-75.

doi: 10.1007/s00198-021-06058-3. Epub 2021 Jul 8.

Authors

Affiliations

¹ Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia. jason.talevski@student.unimelb.edu.au.
² Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia. jason.talevski@student.unimelb.edu.au.
³ Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia.
⁴ Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia.
⁵ School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.
⁶ Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
⁷ Rural Clinical School, The University of Queensland, Toowoomba, Australia.
⁸ Departments of Endocrinology and Medicine, The University of Melbourne/Austin Health, Heidelberg, Victoria, Australia.
⁹ Mary McKillip Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
¹⁰ Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
¹¹ Medical School, Sir Charles Gardner Unit, The University Western Australia, Perth, Western Australia, Australia.
¹² Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.
¹³ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
¹⁴ Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
¹⁵ Quantify Research, Stockholm, Sweden.
¹⁶ Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm, Sweden.
¹⁷ Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
¹⁸ The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine Deakin University, Geelong, Victoria, Australia.
¹⁹ School of Rural Health, Monash University, Victoria, Australia.

PMID: 34235548
DOI: 10.1007/s00198-021-06058-3

Abstract

In this study of 695 Australian older adults (aged ≥50 years), we found that men and women had a similar trajectory of health-related quality of life (HRQoL) recovery following fragility fracture at any skeletal site. These results provide us with critical knowledge that improves our understanding of health outcomes post-fracture.

Introduction: Mortality is higher in men than that in women following a fragility fracture, but it is unclear whether recovery of patient-reported outcomes such as health-related quality of life (HRQoL) differs between sexes. This study aimed to identify sex differences in HRQoL recovery 12 months post-fracture.

Methods: Data were from the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS). Participants recruited to AusICUROS were adults aged ≥50 years who sustained a fragility fracture. HRQoL was measured using the EQ-5D-3L at three time-points post-fracture: within 2 weeks (including pre-fracture recall) and at 4 and 12 months. Multivariate logistic regression analyses were undertaken, adjusting for confounders including age, education, income, and healthcare utilization post-fracture.

Results: Overall, 695 AusICUROS participants (536 women, 77.1%) were eligible for analysis with fractures at the hip (n = 150), distal forearm (n = 261), vertebrae (n = 61), humerus (n = 52), and other skeletal sites (n = 171). At the time of fracture, men were younger, reported a higher income, and were more likely to be employed, compared with women. For all fracture sites combined, there were no differences between men and women in recovery to pre-fracture HRQoL at 12-month follow-up (adjusted OR = 1.09; 95% CI: 0.75-1.61). When stratified by fracture site, no significant sex differences were seen for hip (OR = 1.02; 95% CI: 0.42-2.52), distal forearm (OR = 1.60; 95% CI: 0.68-3.78), vertebral (OR = 2.28; 95% CI: 0.61-8.48), humeral (OR = 1.62; 95% CI: 0.16-9.99), and other fractures (OR = 1.00; 95% CI: 0.44-2.26).

Conclusion: Community-dwelling men and women who survived the 12 months following fragility fracture had a similar trajectory of HRQoL recovery at any skeletal site.

Keywords: Aging; Fractures; Osteoporosis; Quality of life; Sex.

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References

1. Strom O, Borgstrom F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jonsson B (2011) Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155 - PubMed - DOI
1. Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427 - PubMed - DOI
1. Dempster DW (2011) Osteoporosis and the burden of osteoporosis-related fractures. Am J Manag Care 17:S164 - PubMed
1. Borgstrom F, Karlsson L, Ortsater G et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59 - PubMed - PMC - DOI
1. Pisani P, Renna MD, Conversano F, Casciaro E, Di Paola M, Quarta E, Muratore M, Casciaro S (2016) Major osteoporotic fragility fractures: risk factor updates and societal impact. World J Orthop 7:171–181 - PubMed - PMC - DOI

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[1] Strom O, Borgstrom F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jonsson B (2011) Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155 - PubMed - DOI

[2] Strom O, Borgstrom F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jonsson B (2011) Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155 - PubMed - DOI

[3] Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427 - PubMed - DOI

[4] Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427 - PubMed - DOI

[5] Dempster DW (2011) Osteoporosis and the burden of osteoporosis-related fractures. Am J Manag Care 17:S164 - PubMed

[6] Dempster DW (2011) Osteoporosis and the burden of osteoporosis-related fractures. Am J Manag Care 17:S164 - PubMed

[7] Borgstrom F, Karlsson L, Ortsater G et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59 - PubMed - PMC - DOI

[8] Borgstrom F, Karlsson L, Ortsater G et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59 - PubMed - PMC - DOI

[9] Pisani P, Renna MD, Conversano F, Casciaro E, Di Paola M, Quarta E, Muratore M, Casciaro S (2016) Major osteoporotic fragility fractures: risk factor updates and societal impact. World J Orthop 7:171–181 - PubMed - PMC - DOI

[10] Pisani P, Renna MD, Conversano F, Casciaro E, Di Paola M, Quarta E, Muratore M, Casciaro S (2016) Major osteoporotic fragility fractures: risk factor updates and societal impact. World J Orthop 7:171–181 - PubMed - PMC - DOI

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Sex differences in recovery of quality of life 12 months post-fracture in community-dwelling older adults: analyses of the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS)

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Sex differences in recovery of quality of life 12 months post-fracture in community-dwelling older adults: analyses of the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS)

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