Quality of life after hip fracture in the elderly

A systematic literature review

C.M.M. Peeters, E. Visser, C.L.P. van de Ree, T. Gosens, B.L. den Oudsten, J. de Vries

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
With an increasing ageing population, hip fractures have become a major public health issue in the elderly. It is important to examine the health status (HS) and health-related quality of life (HRQOL) of the elderly faced with the epidemic of hip fractures.
Objective
To provide an overview of reported HS and HRQOL in elderly patients with a hip fracture.
Design
A systematic literature search was performed in Embase, Medline, Web of Science, Scopus, CINAHL, Cochrane, PsycINFO, Pubmed, and Google Scholar in July 2014. Studies which reported the HS or HRQOL based on standardised questionnaires in patients older than 65 years with a hip fracture were considered eligible for inclusion.
Results
After inspecting the 2725 potentially eligible studies, 49 fulfilled the inclusion criteria. All included studies were randomised controlled trials or prospective cohort studies. The methodological quality of the studies was moderate. Patients’ functioning on the physical, social, and emotional domains were affected after a hip fracture. The HS and HRQOL of the majority of patients recovered in the first 6 months after fracture. However, their HS did not return to prefracture level. Mental state, prefracture functioning on physical and psychosocial domains, comorbidity, female gender, nutritional status, postoperative pain, length of hospital stay, and complications were factors associated with HS or HRQOL. Treatment with total hip arthroplasty or hemi-arthroplasty provided better HS than treatment with internal fixation with displaced femoral neck fractures. Supportive psychotherapy in “low-functioning” patients, (home) rehabilitation programmes and nutritional supplementation appeared to have beneficial effects on HS.
Conclusions
Optimizing nutrition intake, (home) rehabilitation programmes, and the possibility for psychological counselling in patients with difficulties in the psychosocial dimensions would be recommended after hip fracture surgery. Besides HS questionnaires like EQ-5D and SF-36, adequate measurements like the WHOQOL-Bref or ICECAP-O are warranted in future studies regarding hip fracture surgery and postoperative treatment options.
Keywords
Hip fracture
Health-related quality of life, Health status, Elderly, Systematic review
Original languageEnglish
Pages (from-to)1369-1382
JournalInjury
Volume47
Issue number7
DOIs
Publication statusPublished - 2016

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Length of Stay
Hemiarthroplasty
Femoral Neck Fractures
Nutritional Status
PubMed
Comorbidity
Hip
Surveys and Questionnaires

Cite this

Peeters, C.M.M. ; Visser, E. ; van de Ree, C.L.P. ; Gosens, T. ; den Oudsten, B.L. ; de Vries, J. / Quality of life after hip fracture in the elderly : A systematic literature review. In: Injury. 2016 ; Vol. 47, No. 7. pp. 1369-1382.
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abstract = "BackgroundWith an increasing ageing population, hip fractures have become a major public health issue in the elderly. It is important to examine the health status (HS) and health-related quality of life (HRQOL) of the elderly faced with the epidemic of hip fractures.ObjectiveTo provide an overview of reported HS and HRQOL in elderly patients with a hip fracture.DesignA systematic literature search was performed in Embase, Medline, Web of Science, Scopus, CINAHL, Cochrane, PsycINFO, Pubmed, and Google Scholar in July 2014. Studies which reported the HS or HRQOL based on standardised questionnaires in patients older than 65 years with a hip fracture were considered eligible for inclusion.ResultsAfter inspecting the 2725 potentially eligible studies, 49 fulfilled the inclusion criteria. All included studies were randomised controlled trials or prospective cohort studies. The methodological quality of the studies was moderate. Patients’ functioning on the physical, social, and emotional domains were affected after a hip fracture. The HS and HRQOL of the majority of patients recovered in the first 6 months after fracture. However, their HS did not return to prefracture level. Mental state, prefracture functioning on physical and psychosocial domains, comorbidity, female gender, nutritional status, postoperative pain, length of hospital stay, and complications were factors associated with HS or HRQOL. Treatment with total hip arthroplasty or hemi-arthroplasty provided better HS than treatment with internal fixation with displaced femoral neck fractures. Supportive psychotherapy in “low-functioning” patients, (home) rehabilitation programmes and nutritional supplementation appeared to have beneficial effects on HS.ConclusionsOptimizing nutrition intake, (home) rehabilitation programmes, and the possibility for psychological counselling in patients with difficulties in the psychosocial dimensions would be recommended after hip fracture surgery. Besides HS questionnaires like EQ-5D and SF-36, adequate measurements like the WHOQOL-Bref or ICECAP-O are warranted in future studies regarding hip fracture surgery and postoperative treatment options.KeywordsHip fractureHealth-related quality of life, Health status, Elderly, Systematic review",
author = "C.M.M. Peeters and E. Visser and {van de Ree}, C.L.P. and T. Gosens and {den Oudsten}, B.L. and {de Vries}, J.",
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Quality of life after hip fracture in the elderly : A systematic literature review. / Peeters, C.M.M.; Visser, E.; van de Ree, C.L.P.; Gosens, T.; den Oudsten, B.L.; de Vries, J.

In: Injury, Vol. 47, No. 7, 2016, p. 1369-1382.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Quality of life after hip fracture in the elderly

T2 - A systematic literature review

AU - Peeters, C.M.M.

AU - Visser, E.

AU - van de Ree, C.L.P.

AU - Gosens, T.

AU - den Oudsten, B.L.

AU - de Vries, J.

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N2 - BackgroundWith an increasing ageing population, hip fractures have become a major public health issue in the elderly. It is important to examine the health status (HS) and health-related quality of life (HRQOL) of the elderly faced with the epidemic of hip fractures.ObjectiveTo provide an overview of reported HS and HRQOL in elderly patients with a hip fracture.DesignA systematic literature search was performed in Embase, Medline, Web of Science, Scopus, CINAHL, Cochrane, PsycINFO, Pubmed, and Google Scholar in July 2014. Studies which reported the HS or HRQOL based on standardised questionnaires in patients older than 65 years with a hip fracture were considered eligible for inclusion.ResultsAfter inspecting the 2725 potentially eligible studies, 49 fulfilled the inclusion criteria. All included studies were randomised controlled trials or prospective cohort studies. The methodological quality of the studies was moderate. Patients’ functioning on the physical, social, and emotional domains were affected after a hip fracture. The HS and HRQOL of the majority of patients recovered in the first 6 months after fracture. However, their HS did not return to prefracture level. Mental state, prefracture functioning on physical and psychosocial domains, comorbidity, female gender, nutritional status, postoperative pain, length of hospital stay, and complications were factors associated with HS or HRQOL. Treatment with total hip arthroplasty or hemi-arthroplasty provided better HS than treatment with internal fixation with displaced femoral neck fractures. Supportive psychotherapy in “low-functioning” patients, (home) rehabilitation programmes and nutritional supplementation appeared to have beneficial effects on HS.ConclusionsOptimizing nutrition intake, (home) rehabilitation programmes, and the possibility for psychological counselling in patients with difficulties in the psychosocial dimensions would be recommended after hip fracture surgery. Besides HS questionnaires like EQ-5D and SF-36, adequate measurements like the WHOQOL-Bref or ICECAP-O are warranted in future studies regarding hip fracture surgery and postoperative treatment options.KeywordsHip fractureHealth-related quality of life, Health status, Elderly, Systematic review

AB - BackgroundWith an increasing ageing population, hip fractures have become a major public health issue in the elderly. It is important to examine the health status (HS) and health-related quality of life (HRQOL) of the elderly faced with the epidemic of hip fractures.ObjectiveTo provide an overview of reported HS and HRQOL in elderly patients with a hip fracture.DesignA systematic literature search was performed in Embase, Medline, Web of Science, Scopus, CINAHL, Cochrane, PsycINFO, Pubmed, and Google Scholar in July 2014. Studies which reported the HS or HRQOL based on standardised questionnaires in patients older than 65 years with a hip fracture were considered eligible for inclusion.ResultsAfter inspecting the 2725 potentially eligible studies, 49 fulfilled the inclusion criteria. All included studies were randomised controlled trials or prospective cohort studies. The methodological quality of the studies was moderate. Patients’ functioning on the physical, social, and emotional domains were affected after a hip fracture. The HS and HRQOL of the majority of patients recovered in the first 6 months after fracture. However, their HS did not return to prefracture level. Mental state, prefracture functioning on physical and psychosocial domains, comorbidity, female gender, nutritional status, postoperative pain, length of hospital stay, and complications were factors associated with HS or HRQOL. Treatment with total hip arthroplasty or hemi-arthroplasty provided better HS than treatment with internal fixation with displaced femoral neck fractures. Supportive psychotherapy in “low-functioning” patients, (home) rehabilitation programmes and nutritional supplementation appeared to have beneficial effects on HS.ConclusionsOptimizing nutrition intake, (home) rehabilitation programmes, and the possibility for psychological counselling in patients with difficulties in the psychosocial dimensions would be recommended after hip fracture surgery. Besides HS questionnaires like EQ-5D and SF-36, adequate measurements like the WHOQOL-Bref or ICECAP-O are warranted in future studies regarding hip fracture surgery and postoperative treatment options.KeywordsHip fractureHealth-related quality of life, Health status, Elderly, Systematic review

U2 - 10.1016/j.injury.2016.04.018

DO - 10.1016/j.injury.2016.04.018

M3 - Article

VL - 47

SP - 1369

EP - 1382

JO - Injury

JF - Injury

SN - 0020-1383

IS - 7

ER -