Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: The International Costs and Utilities Related to Osteoporotic fractures Study (ICUROS) is an ongoing 18 months prospective observational study with the objective of estimating resource use and health related quality of life (HRQoL) related to osteoporotic fractures. This study aims to describe the resource utilization for hip fractures pooled from 10 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain and the UK).
Methods: We studied 2,407 patients with low-energy hip fracture sustained from 2007 to 2012. For the purpose of the present study patients had to be ≥ 50 years, live in their own home prior to the fracture, and have had the first study interview within 2 weeks after fracture. Data were collected through patient interviews and review of medical records in four phases (at baseline, Month 4, 12, and 18). Key data included patient reported HRQoL (EQ-5D), and resource utilization due to the fracture. HRQoL before fracture was collected immediately after fracture. Patients with complete data at each follow-up were included in the analyses. The EQ-5D is a HRQoL instrument consisting five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) with 243 possible response combinations. These health states can be translated into health utilities on a unison scale using UK population based preference values (range -0.59 to 1; 1 for full health, 0 for dead, below 0 for health states worse than dead) [1].
Results: There were 1795, 1435, 1256 patients available for analysis at the 4, 12 and 18 months follow-up, respectively. The mean age (±SD) at fracture was 77±10 years and 79% were women. Emergency or traumatology departments were the first point of contact with the healthcare system for 89% of patients. 96% of patients were hospitalized and the mean hospital length of stay due to the fracture (±SD) was 17.2±20.4 days. During the first four months after fracture, the mean number of physician, nurse and physiotherapy visits related to the fracture were estimated at 2.8±3.1, 2.4±9.6, and 8.2±13 respectively. During the same time period, 65% of patients used analgesics, 41% calcium/vitamin D, and 27% pharmacological interventions for osteoporosis. The mean utility was 0.75±0.28 before fracture, -0.13±0.37 after fracture, 0.48±0.39 at Month 4, 0.58±0.37 at Month 12, and 0.66±0.36 at Month 18 following the fracture.
Conclusion: Hip fractures were associated with severe immediate loss in HRQoL. The mean health utility was estimated at -0.13 directly after fracture, which is worse than death on the 0 (death) to 1 (full health) scale. Whereas patients gradually recovered, the mean health utility estimate of 0.66 at 18 months after fracture (compared to 0.75 prior to fracture) show that, on average, hip fractures result in substantial and persistent long-term loss in HRQoL. In addition, the mean hospital length of stay of 17.2 days suggests that hip fractures are associated with substantial costs to society.
References
1. Dolan, P., Modeling valuations for EuroQol health states. Med Care, 1997. 35(11): p. 1095-108.
Disclosure:
M. Ivergård,
OptumInsight,
3;
V. Wintzell,
OptumInsight,
3;
L. B. Tankó,
Novartis Pharma AG,
3;
V. Barghout,
Novartis Pharma AG,
5;
A. Svedbom,
OptumInsight,
3;
V. Alekna,
ICUROS,
2;
M. L. Bianchi,
ICUROS ,
2;
P. Clark,
ICUROS ,
2;
M. Díaz Curiel,
ICUROS,
2;
H. P. Dimai,
ICUROS ,
2;
M. Jürisson,
ICUROS,
2;
O. Lesnyak,
ICUROS,
2;
E. McCloskey,
ICUROS,
2;
K. M. Sanders,
ICUROS,
2;
T. Thomas,
ICUROS,
2;
F. Borgström,
ICUROS,
2;
J. A. Kanis,
ICUROS,
2.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-quality-of-life-and-resource-use-related-to-hip-fractures-based-on-data-from-the-international-costs-and-utilities-related-to-osteoporotic-fractures-study/