Original Article

Factors Affecting Quality of Life at Discharge among Patients with Osteoporotic Vertebral Fractures

Authors: Takuya Umehara, PT, PhD, Ayaka Inukai, PT, Daisuke Kuwahara, PT, BS, Ryo Kaneyashiki, PT, BS, Akinori Kaneguchi, PT, PhD, Miwako Tsunematsu, RN, PhD, Masayuki Kakehashi, PhD, DSc

Abstract

Objectives: This study aimed to identify factors, including physical functions and activities that affect quality of life (QOL) at discharge among patients with osteoporotic vertebral fractures.

Methods: Patients with osteoporotic vertebral fractures were included in our prospective cohort study. Multiple regression analysis was performed to determine the predictors of QOL at discharge using two models: model 1, basic medical information and physical functions at admission, and model 2, basic medical information, physical function, and activity after 4 weeks of admission.

Results: Multiple regression analysis (standard partial regression coefficients) using model 1 identified L2 to L4 bone mineral density (−0.2), Visual Analog Scale for pain during activity at admission (−0.31), and Revised Hasegawa Dementia Scale (HDS-R) score at admission (0.64) as factors affecting QOL at discharge. Multiple regression analysis using model 2 identified HDS-R at admission (0.64), Pain Catastrophizing Scale score at 4 weeks (−0.34), and knee extension muscle strength at 4 weeks (0.28) as factors affecting QOL at discharge.

Conclusions: Our results suggest that if patients have high bone mineral density, intense pain, and low cognitive function at admission, then low QOL at discharge will be predicted; however, improvement of pain catastrophizing and knee extension muscle strength during first the 4 weeks of admission may be able to improve QOL at discharge. Because patients in this study were Japanese only, it is important to exercise caution when applying our results to other populations.
Posted in: Metabolic & Other Bone Disease (Osteoporosis)6

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Ross PD, Fujiwara S, Huang C, et al. Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US. Int J Epidemiol 1995;24:1171–1177.   2. Ettinger B, Black DM, Nevitt MC, et al. Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 1992;7:449–456.   3. Silverman SL, Minshall ME, Shen W, et al. Health-Related Quality of Life Subgroup of the Multiple Outcomes of Raloxifene Evaluation Study. The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 2001;44:2611–2619.   4. Harrison RA, Siminoski K, Vethanayagam D, et al. Osteoporosis-related kyphosis and impairments in pulmonary function: a systematic review. Bone Miner Res 2007;22:447–457.   5. Al-Sari UA, Tobias J, Clark E. Health-related quality of life in older people with osteoporotic vertebral fractures: a systematic review and meta-analysis. Osteoporos Int 2016;27:2891–2900.   6. Guo JB, Zhu Y, Chen BL, et al. Surgical versus non-surgical treatment for vertebral compression fracture with osteopenia: a systematic review and meta-analysis. PLoS One 2015;10:e0127145.   7. Giangregorio LM, Macintyre NJ, Thabane L, et al. Exercise for improving outcomes after osteoporotic vertebral fracture. Cochrane Database Syst Rev 2013;1:CD008618.   8. Hoshino M, Tsujio T, Terai H, et al. Impact of initial conservative treatment interventions on the outcomes of patients with osteoporotic vertebral fractures. Spine 2013;3:E641–E648.   9. Jung HJ, Park YS, Seo HY, et al. Quality of life in patients with osteoporotic vertebral compression fractures. J Bone Metab 2017;24:187–196.   10. Genant HK, Wu CY, van Kuijk C, et al. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993;8:1137–1148.   11. Kanis JA, Johnell O, Oden A, et al. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 2001;12:989–995.   12. Matsuoka H, Sakano Y. Assessment of cognitive aspect of pain: development, reliability, and validation of Japanese version of pain catastrophizing scale. Jpn J Psychosom Med 2007;47:95–102 (in Japanese).   13. Tanaka K, Nishigami T, Mibu A, et al. Validation of the Japanese version of the Central Sensitization Inventory in patients with musculoskeletal disorders. PLoS One 2017;12:e0188719.   14. Katoh M, Isozaki K. Reliability of isometric knee extension muscle strength measurements of healthy elderly subjects made with a hand-held dynamometer and a belt. J Phys Ther Sci 2014;26:1855–1859.   15. Lenzlinger-Asprion R, Keller N, Meichtry A, et al. Intertester and intratester reliability of movement control tests on the hip for patients with hip osteoarthritis. BMC Musculoskelet Disord 2017;18:55.   16. Imai Y, Hasegawa K. The Revised Hasegawa’s Dementia Scale (HDS-R)— evaluation of its usefulnesss as a screening test for dementia. East Asian Arch Psychiatry 1994;4:20–24.   17. Horiuchi T, Kobayashi Y, Hosoi T, et al. The assessment of the reliability and the validity of the EOQOL questionnaire of osteoporotics—QOL assessment of elderly osteoporotoes by EOQOL. Jpn J Geriatr 2005;42:229–234 (in Japanese).   18. Shohrati M, Bayat N, Saburi A, et al. Effect of nasal calcitonin on the health-related quality of life in postmenopause women affected with low bone density. Iran Red Crescent Med J 2015;17:e6613.   19. Salaffi F, Cimmino MA, Malavolta N, et al. The burden of prevalent fractures on health-related quality of life in postmenopausal women with osteoporosis: the IMOF study. J Rheumatol 2007;34:1551–1560.   20. Grbovic V, Jurisic Skevin A, Parezanovic llic K, et al. Correlations between clinical parameters and health-related quality of life in postmenopausal osteoporotic women. Serbian J Exp Clin Res 2016;17:333–342.   21. Joakimsen RM, Magnus JH, Fønnebø V. Physical activity and predisposition for hip fractures: a review. Osteoporos Int 1997;7:503–513.   22. Stanghelle B, Bentzen H, Giangregorio L, et al. Associations between health-related quality of life, physical function and pain in older women with osteoporosis and vertebral fracture. BMC Geriatr 2019;19:298.   23. American Geriatrics Society Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. J Am Geriatr Soc 2002;50:S205–S224.   24. Takai Y, Yamamoto N, Ko A. Prevalence of and factors related to pain among elderly Japanese residents in long-term healthcare facilities. Geriatr Gerontol Int 2014;14:481–489.   25. Farina N, Page TE, Daley S, et al. Factors associated with the quality of life of family carers of people with dementia: a systematic review. Alzheimers Dement 2017;13:572–581.   26. Salminen Ks, Suominen Mh, Kautiainen H, et al. Energy intake and severity of dementia are both associated with health-related quality of life among older long-term care residents. Nutrients 2019;11:2261.   27. Logsdon RG, Gibbons LE, McCurry SM, et al. Assessing quality of life in older adults with cognitive impairment. Psychosom Med 2002;64:510–519.   28. Hayashi K, Morishima T, Ikemoto T, et al. Pain catastrophizing is independently associated with quality of life in patients with severe hip osteoarthritis. Pain Med 2019;20:2220–2227.   29. Carter ND, Khan KM, Mallinson A, et al. Knee extension strength is a significant determinant of static and dynamic balance as well as quality of life in older community-dwelling women with osteoporosis. Gerontology 2002;48:360–368.   30. Zengin A, Prentice A, Ward KA. Ethnic differences in bone health. Front Endocrinol (Lausanne) 2015;6:24.   31. Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 1998;280:2077–2082.