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Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the global longitudinal study of osteoporosis in women (GLOW)

Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the global longitudinal study of osteoporosis in women (GLOW)
Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the global longitudinal study of osteoporosis in women (GLOW)
Summary
Among 50,461 postmenopausal women, 1,822 fractures occurred (57% minor non-hip, non-vertebral [NHNV], 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D, followed by major NHNV and hip fractures. Decreases in physical function and health status were greatest for spine or hip fractures.

Introduction
There is growing evidence that NHNV fractures result in substantial morbidity and healthcare costs. The aim of this prospective study was to assess the effect of these NHNV fractures on quality of life.

Methods
We analyzed the 1-year incidences of hip, spine, major NHNV (pelvis/leg, shoulder/arm) and minor NHNV (wrist/hand, ankle/foot, rib/clavicle) fractures among women from the Global Longitudinal study of Osteoporosis in Women (GLOW). Health-related quality of life (HRQL) was analyzed using the EuroQol EQ-5D tool and the SF-36 health survey.

Results
Among 50,461 women analyzed, there were 1,822 fractures (57% minor NHNV, 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D summary scores, followed by major NHNV and hip fractures. The number of women with mobility problems increased most for those with major NHNV and spine fractures (both +8%); spine fractures were associated with the largest increases in problems with self care (+11%), activities (+14%), and pain/discomfort (+12%). Decreases in physical function and health status were greatest for those with spine or hip fractures. Multivariable modeling found that EQ-5D reduction was greatest for spine fractures, followed by hip and major/minor NHNV. Statistically significant reductions in SF-36 physical function were found for spine fractures, and were borderline significant for major NHNV fractures.

Conclusion
This prospective study shows that NHNV fractures have a detrimental effect on HRQL. Efforts to optimize the care of osteoporosis patients should include the prevention of NHNV fractures.
0937-941X
2863-2871
Roux, C.
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Wyman, A.
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Hooven, F.H.
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Gehlbach, S.H.
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Adachi, J.D.
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Chapurlat, R.D.
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Compston, J.E.
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Cooper, C.
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Diez-Perez, A.
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Greenspan, S.L.
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LaCroix, A.Z.
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Netelenbos, J.C.
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Pfeilschifter, J.
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Rossini, M.
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Saag, K.G.
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Sambrook, P.N.
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Silverman, S.
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Siris, E.S.
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Watts, N.B.
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Boonen, S.
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Roux, C.
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Wyman, A.
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Hooven, F.H.
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Gehlbach, S.H.
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Adachi, J.D.
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Chapurlat, R.D.
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Compston, J.E.
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Cooper, C.
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Diez-Perez, A.
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Greenspan, S.L.
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LaCroix, A.Z.
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Netelenbos, J.C.
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Pfeilschifter, J.
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Rossini, M.
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Saag, K.G.
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Sambrook, P.N.
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Silverman, S.
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Siris, E.S.
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Watts, N.B.
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Boonen, S.
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Roux, C., Wyman, A. and Hooven, F.H. et al. (2012) Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the global longitudinal study of osteoporosis in women (GLOW). Osteoporosis International, 23 (12), 2863-2871. (doi:10.1007/s00198-012-1935-8). (PMID:22398855)

Record type: Article

Abstract

Summary
Among 50,461 postmenopausal women, 1,822 fractures occurred (57% minor non-hip, non-vertebral [NHNV], 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D, followed by major NHNV and hip fractures. Decreases in physical function and health status were greatest for spine or hip fractures.

Introduction
There is growing evidence that NHNV fractures result in substantial morbidity and healthcare costs. The aim of this prospective study was to assess the effect of these NHNV fractures on quality of life.

Methods
We analyzed the 1-year incidences of hip, spine, major NHNV (pelvis/leg, shoulder/arm) and minor NHNV (wrist/hand, ankle/foot, rib/clavicle) fractures among women from the Global Longitudinal study of Osteoporosis in Women (GLOW). Health-related quality of life (HRQL) was analyzed using the EuroQol EQ-5D tool and the SF-36 health survey.

Results
Among 50,461 women analyzed, there were 1,822 fractures (57% minor NHNV, 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D summary scores, followed by major NHNV and hip fractures. The number of women with mobility problems increased most for those with major NHNV and spine fractures (both +8%); spine fractures were associated with the largest increases in problems with self care (+11%), activities (+14%), and pain/discomfort (+12%). Decreases in physical function and health status were greatest for those with spine or hip fractures. Multivariable modeling found that EQ-5D reduction was greatest for spine fractures, followed by hip and major/minor NHNV. Statistically significant reductions in SF-36 physical function were found for spine fractures, and were borderline significant for major NHNV fractures.

Conclusion
This prospective study shows that NHNV fractures have a detrimental effect on HRQL. Efforts to optimize the care of osteoporosis patients should include the prevention of NHNV fractures.

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Published date: December 2012
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 348288
URI: http://eprints.soton.ac.uk/id/eprint/348288
ISSN: 0937-941X
PURE UUID: 64eb8358-8b6a-4256-9eeb-b0276d294605
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 12 Feb 2013 14:13
Last modified: 03 Dec 2019 01:58

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Contributors

Author: C. Roux
Author: A. Wyman
Author: F.H. Hooven
Author: S.H. Gehlbach
Author: J.D. Adachi
Author: R.D. Chapurlat
Author: J.E. Compston
Author: C. Cooper ORCID iD
Author: A. Diez-Perez
Author: S.L. Greenspan
Author: A.Z. LaCroix
Author: J.C. Netelenbos
Author: J. Pfeilschifter
Author: M. Rossini
Author: K.G. Saag
Author: P.N. Sambrook
Author: S. Silverman
Author: E.S. Siris
Author: N.B. Watts
Author: S. Boonen

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