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Health-related quality of life and radiographic vertebral fracture

Health-related quality of life and radiographic vertebral fracture
Health-related quality of life and radiographic vertebral fracture
Background: Vertebral fractures are associated with back pain and disability; however, relatively little is known about the impact of radiographic vertebral fractures on quality of life in population samples. The aim of this study was to determine the impact of a recent radiographic vertebral fracture on health-related quality of life (HRQoL). Methods: Men and women aged 50 years and over were recruited from population registers in 12 European centers. Subjects completed an interviewer-administered questionnaire and had lateral spine radiographs performed. Subjects in these centers were followed prospectively and had repeat spinal radiographs performed a mean of 3.8 years later. Prevalent deformities were defined using established morphometric criteria, and incident vertebral fractures by both morphometric criteria and qualitative assessment. For each incident fracture case, three controls matched for age, gender, and center were selected: one with a prevalent deformity (at baseline) and two without prevalent deformities. All subjects were interviewed or completed a postal questionnaire instrument which included Short Form 12 (SF-12), the EQ-5D (former EuroQol), and the quality of life questionnaire of the International Osteoporosis Foundation (QUALEFFO). The median time from the second spinal radiograph until the quality of life survey was 1.9 years. Comparison between cases and their matched controls was undertaken using the signed rank test. Results: 73 subjects with incident vertebral fracture (cases), mean age 64.8 years (of whom 23 had a baseline deformity), and 196 controls, mean age 63.9 years (of whom 60 had a baseline deformity), were studied. There were strong correlations between the domain scores for each of the three instruments. There was no statistically significant difference in any of the domain scores between cases and those controls with a prevalent deformity. However, compared with the controls without a prevalent deformity the cases had significantly impaired quality of life as determined using the total QUALEFFO score (38.2 vs 33.7), the physical component score of the SF-12 (39.9 vs 43.7) and the health status score of the EQ-5D (62.3 vs 69.9). When the analysis was repeated after stratification of the cases by baseline deformity status (i.e., cases with and without a prevalent deformity at baseline), cases with a prevalent deformity had impaired quality of life compared with their matched controls, both with and without a prevalent deformity. In contrast there was no significant difference in quality of life among the cases without a prevalent deformity and either control group. Conclusion: In this population-based study a recent vertebral fracture was associated with impairment in quality of life, though this was mainly among those who had sustained a previous vertebral deformity.
health impact, osteoporosis, quality of life, vertebral fracture
0937-941X
113-119
Cockerill, W.
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Lunt, M.
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Silman, A.J.
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Cooper, C.
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Lips, P.
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Bhalla, A.K.
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Cannata, J.B.
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Eastell, R.
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Felsenberg, D.
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Gennari, C.
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Johnell, O.
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Kanis, J.A.
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Kiss, C.
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Masaryk, P.
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Naves, M.
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Poor, G.
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Raspe, H.
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Reid, D.M.
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Reeve, J.
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Stepan, J.
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Todd, C.
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Woolf, A.D.
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O'Neill, T.W.
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Cockerill, W.
cd79b232-2a11-45d9-96ca-650f0c33d10a
Lunt, M.
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Silman, A.J.
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Cooper, C.
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Lips, P.
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Bhalla, A.K.
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Cannata, J.B.
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Eastell, R.
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Felsenberg, D.
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Gennari, C.
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Johnell, O.
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Kanis, J.A.
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Kiss, C.
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Masaryk, P.
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Naves, M.
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Poor, G.
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Raspe, H.
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Reid, D.M.
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Reeve, J.
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Stepan, J.
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Todd, C.
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Woolf, A.D.
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O'Neill, T.W.
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Cockerill, W., Lunt, M., Silman, A.J., Cooper, C., Lips, P., Bhalla, A.K., Cannata, J.B., Eastell, R., Felsenberg, D., Gennari, C., Johnell, O., Kanis, J.A., Kiss, C., Masaryk, P., Naves, M., Poor, G., Raspe, H., Reid, D.M., Reeve, J., Stepan, J., Todd, C., Woolf, A.D. and O'Neill, T.W. (2004) Health-related quality of life and radiographic vertebral fracture. Osteoporosis International, 15 (2), 113-119. (doi:10.1007/s00198-003-1547-4).

Record type: Article

Abstract

Background: Vertebral fractures are associated with back pain and disability; however, relatively little is known about the impact of radiographic vertebral fractures on quality of life in population samples. The aim of this study was to determine the impact of a recent radiographic vertebral fracture on health-related quality of life (HRQoL). Methods: Men and women aged 50 years and over were recruited from population registers in 12 European centers. Subjects completed an interviewer-administered questionnaire and had lateral spine radiographs performed. Subjects in these centers were followed prospectively and had repeat spinal radiographs performed a mean of 3.8 years later. Prevalent deformities were defined using established morphometric criteria, and incident vertebral fractures by both morphometric criteria and qualitative assessment. For each incident fracture case, three controls matched for age, gender, and center were selected: one with a prevalent deformity (at baseline) and two without prevalent deformities. All subjects were interviewed or completed a postal questionnaire instrument which included Short Form 12 (SF-12), the EQ-5D (former EuroQol), and the quality of life questionnaire of the International Osteoporosis Foundation (QUALEFFO). The median time from the second spinal radiograph until the quality of life survey was 1.9 years. Comparison between cases and their matched controls was undertaken using the signed rank test. Results: 73 subjects with incident vertebral fracture (cases), mean age 64.8 years (of whom 23 had a baseline deformity), and 196 controls, mean age 63.9 years (of whom 60 had a baseline deformity), were studied. There were strong correlations between the domain scores for each of the three instruments. There was no statistically significant difference in any of the domain scores between cases and those controls with a prevalent deformity. However, compared with the controls without a prevalent deformity the cases had significantly impaired quality of life as determined using the total QUALEFFO score (38.2 vs 33.7), the physical component score of the SF-12 (39.9 vs 43.7) and the health status score of the EQ-5D (62.3 vs 69.9). When the analysis was repeated after stratification of the cases by baseline deformity status (i.e., cases with and without a prevalent deformity at baseline), cases with a prevalent deformity had impaired quality of life compared with their matched controls, both with and without a prevalent deformity. In contrast there was no significant difference in quality of life among the cases without a prevalent deformity and either control group. Conclusion: In this population-based study a recent vertebral fracture was associated with impairment in quality of life, though this was mainly among those who had sustained a previous vertebral deformity.

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Published date: 2004
Keywords: health impact, osteoporosis, quality of life, vertebral fracture

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Local EPrints ID: 25372
URI: http://eprints.soton.ac.uk/id/eprint/25372
ISSN: 0937-941X
PURE UUID: 20b549e7-6607-4f69-8fc6-c29b62b303c3
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 10 Apr 2006
Last modified: 10 Dec 2019 01:52

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Contributors

Author: W. Cockerill
Author: M. Lunt
Author: A.J. Silman
Author: C. Cooper ORCID iD
Author: P. Lips
Author: A.K. Bhalla
Author: J.B. Cannata
Author: R. Eastell
Author: D. Felsenberg
Author: C. Gennari
Author: O. Johnell
Author: J.A. Kanis
Author: C. Kiss
Author: P. Masaryk
Author: M. Naves
Author: G. Poor
Author: H. Raspe
Author: D.M. Reid
Author: J. Reeve
Author: J. Stepan
Author: C. Todd
Author: A.D. Woolf
Author: T.W. O'Neill

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