Ramírez-Pérez E, Clark P, Deleze M, Cons-Molina F, Morales-Torres J, Diez-García P

Language: English
References: 21
Page: 225-233
PDF size: 153.39 Kb.

ABSTRACT

Objective. To measure the impact on the health-related quality of life (HRQoL) of a sample of Mexicans with vertebral fractures. Material and methods. One hundred fifteen subjects with vertebral fractures were interviewed and compared with 135 subjects similar in age without the fracture. Subjects were men and women › 50 years of age with osteoporosis confirmed by bone mineral densitometry and with at least 1 vertebral fracture verified by vertebral morphometry and Xrays. The sample was recruited from two sources: The Clínica de Osteoporosis at the Instituto Nacional de Rehabilitación and a random sample from the Latin American Osteoporosis Study. The Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) validated in Spanish for the Mexican population was applied. Descriptive statistics were used for demographic and clinical aspects of the sample, as well as χ² for categorical variables and Student t test for independent samples for continuous variables. A multiple linear regression (LR) was conducted to characterize predictive variables related to quality of life. Results. Two hundred fifty subjects were interviewed; 64% of them were women. The average age of those interviewed was 73.4 ± 11.4 years; 46% of the sample had vertebral fractures; of them 43% of were lumbar and 57% thoracic; the most frequent site was L1-T12. Significant changes were found in the group with fractures in pain, physical function, social function, and mental function (p ‹ 0.05); in women, pain and social function were different between groups (p ‹ 0.05); and those over 70 years also presented differences in physical, social, and mental function (p ‹ 0.05); differences were found associated with the place of recruitment being worse in their quality of life those coming from the Clínica de Osteoporosis. Two or more fractures, age, being female and widowed were significant predictors for greater deterioration of HRQoL with the LR. Conclusion. This is the first study looking at the HRQoL in osteoporosis related fractures in Mexicans were quality of life deterioration on physical, social, and emotional functioning was demonstrated in subjects with two vertebral fractures. Age is a determining factor for greater deterioration in all studied domains. Differences between the samples obtained at the Clínica de Osteoporosis at the Instituto Nacional de Rehabilitación and the random population exemplifying that asymptomatic fractures are common and not diagnosed. It is important to scrutinize vertebral fractures at the first level because their timely detection allows for their evaluation and treatment and diminishes the probability of a second fracture. Our results can be generalized to men and women over 50 who live in the central megalopolis and in other states of the Valley of México.

REFERENCES

1. Papaioannou A, Kennedy CC, Ioannidis G, Brown JP, Pathak A, Hanley DA, Josse RG, et al. Determinants of health-related quality of life in women with vertebral fractures. Osteoporosis Int 2006; 17: 355-63.

2. Cummings SR, et al. Risk factors for hip fracture in white women. N Engl J Med 1995; 332: 767-73.

3. Black DM, et al. Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. J Bone Miner Res 1999; 14: 821-8.

4. Ross PD, et al. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 1991; 114: 919-23.

5. Clark P, Cons-Molina F, Deleze M, Talavera JO, Palermo L, Cummings SO. The prevalence of radiographic vertebral fractures in Mexican men. Osteoporosis Int 2010; 21: 1523-8.

6. Clark P, Cons MF, Delezé M, Ragi S, et al. The prevalence of radiographic vertebral fractures in Latin American countries the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporosis Int 2009; 20(2): 275-82.

7. Haczynski J, Jakimiuk A. Vertebral fractures: a hidden problem of osteoporosis. Med Sci Monit 2001; 7(5): 1108-17.

8. Cook DJ, Guyatt GH, Adachi JD, et al. Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum 1993; 156: 2469-75.

9. Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J. Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 2000; 15(7): 1384-92.

10. Hall SE, Criddle RA, Comito TL, et al. A case control study of quality of life and functional impairment in women with long standing vertebral osteoporotic fracture. Osteoporosis Int 1999; 9: 508-15.

11. Gold DT. The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 1996; 18: 185S-189S.

12. Ettinger B, Block JE, Smith R, et al. An examination of the association between vertebral deformities, physical disabilities and psychosocial problems. Maturitas 1988; 10: 283-96.

13. WHO. Assessment of fracture risk and its application to screening for postmenopausal Osteoporosis. Report of the WHO Study Group. Geneva, Switzerland: WHO; 1994; Technical Report Series No. 843.

14. Ramírez E, Clark P, Wacher N, Cardiel M, Diez GMP. Cultural adaptation and validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) in a Mexican population. Clin Rheumatol 2008; 27(2): 151-61.

15. Lips P, Cooper C, Agnusdei D, et al. Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporosis Int 1999; 10: 150-60.

16. Silverman SL, Minshall ME, Shen W, Harper KD, Xie S. 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(11): 2611-9.

17. Fink HA, Ensrud KE, Nelson DB, Kerani RP, Schreiner PJ, Zhao Y, et al. Disability after clinical fracture in post menopausal women with low bone density. The Fracture Intervention Trial (FIT). Osteoporosis Int 2003; 14: 69-76.

18. Oleksik AM, Ewing S, Shen W, van Schoor NM, Lips P. Impact of incident vertebral fractures on health related quality of life (HRQOL) in postmenopausal women with prevalent vertebral fractures. Osteoporosis Int 2005; 16(8): 861-70 Ramírez-Pérez E, et al. Impact of osteoporosis-associated vertebral fractures on health-related quality of life. Rev Invest Clin 2014; 66 (3): 225-233 233

19. Fechtenbaum J, Cropet C, Kolta S, Horlait S, Orcel P, Roux C. The severity of vertebral fractures and health-related quality of life in osteoporotic postmenopausal women. Osteoporosis Int 2005; 16(12): 2175-9.

20. Sanfélix-Genovés J, Hurtado I, Sanfélix-Gimeno G, Reig-Molla B, Peiró S. Impact of osteoporosis and vertebral fractures on quality-of-life. A population-based study in Valencia, Spain (The FRAVO Study). Health Qual Life Outcomes 2011; 6: 9-20.

21. Disponible en: http://poblacion.hidalgo.gob.mx/descargables/ Dx_Mega/Megalopolis en Mexico.pdf