The impact of hip fracture on health-related quality of life and activities of daily living: the SPARE-HIP prospective cohort study

Abstract

Purpose: The medical morbidity and mortality associated with neck of femur fractures is well-documented, whereas there is limited data for patient-reported outcomes. The aim of this study was to characterize the impact of neck of femur fractures on activities of daily living and patient-reported health-related quality of life. Methods: Design and participants: Multicentric prospective cohort study. Consecutive sample patients with fragility hip fracture over 50years old admitted in 48 hospitals in Spain. Outcomes: daily living activity function (Barthel Index) and health-related quality of life (EQ-5D) pre-fracture, admission to hospital and at 1- and 4-month follow-up post-fracture.Statistics: Barthel and EQ-5D over time are described as mean (SD) and median (interquartile range).ResultsA total of 997 patients were recruited at baseline with 4-month outcomes available for, and 856 patients (89.5%). Barthel Index fell from 78.77 (23.75) at baseline to 43.62 (19.86) on admission to hospital with the fracture. Scores partially recovered to 54.89 (25.40) and 64.09 (21.35) at 1- and 4-month post-fracture, respectively. EQ-5D fell from a median of 0.75 (0.47-0.91) to -0.01 (-0.03 to 0.51) on admission. Partial recovery was observed again to (0.51 (-0.06 to 0.67)) and (0.60 (0.10 to 0.80)) at 1- and 4-month post-fracture, respectively. Conclusions: Hip fracture results in a large decline in the ability to perform activities of daily living and patient-reported health-related quality of life with only partial recovery amongst survivors 4-month post-fracture.