A longitudinal latent class analysis of health-related quality of life post pelvic fractures; the BIOS cohort study

Background: The objective of this study was to identify latent profiles in the HRQoL recovery of patients with pelvic fractures and examine demographic, psychological, and medical determinants. Methods: 184 patients (Mage = 58.3 +/- 16.9, 59 % male) from the BIOS study were included. HRQoL was assessed six times across two years. At 1-week post-injury, additional pre-injury HRQoL (EQ-5D-3L), psychological (HADS, IES), and functional (MPS, MAHS) measures were assessed. A 3-step repeated measures latent class analysis (RMLCA) identified latent profiles in HRQoL and examined their correlates. Results: Four similar recovery profiles for the EQ-5D domains of VAS, mobility, and usual activities were identified: low/poor, intermediate/partial, high/full, and prominent improvement/fast & full recovery. For the EQ5D domains of pain/discomfort, self-care, and anxiety/depression, three similar profiles were identified: poor recovery, partial recovery/intermediate problems, and full recovery/ no pain. Higher emotional distress, comorbidities, and complications were associated with the low VAS profile. Older age, pelvic ring fracture, pelvic surgery, higher ISS, lower emotional distress, and higher pre-injury HRQoL levels were associated with the prominent improvement VAS profile. Better physical functioning was associated with the intermediate and high VAS profiles. Conclusions: Results unveiled person-level heterogeneity evidenced by the four latent recovery trajectories of HRQoL following pelvic fracture and their distinct associated covariates, among which psychological functioning, which significantly contributed to HRQoL recovery. Future research should focus on the development of adequate screening tools facilitating decision-making applications which in turn can optimize personalized treatment programs. The current findings offer valuable insights to aid in this developmental process.