J Bone Metab.  2016 Nov;23(4):199-206. 10.11005/jbm.2016.23.4.199.

Health-related Quality of Life in Accordance with Fracture History and Comorbidities in Korean Patients with Osteoporosis

Affiliations
  • 1Division of Biology and Public Health, Mokwon University, Daejeon, Korea.
  • 2Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
  • 3Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. furim@daum.net

Abstract

BACKGROUND
The purpose of this study was to explore health-related quality of life (HRQOL) among Korean patients with osteoporosis and to measure the impact of fractures and comorbidity on their quality of life (QOL) using the Korean National Health and Nutrition Examination Survey (KNHANES) data with a nationwide representativeness.
METHODS
This study was based on 4-year-data obtained from the KNHANES 2008 to 2011. Osteoporosis was diagnosed in 2,078 survey participants according to their bone mineral density measurements using dual energy X-ray absorptiometry. According to the World Health Organization study group, T-scores at or above -1.0 are considered normal, those between -1.0 and -2.5 as osteopenia, and those at or below -2.5 as osteoporosis The EuroQol five-dimensional questionnaire (EQ-5D) index score was used to assess the QOL.
RESULTS
Of 2,078 patients diagnosed with osteoporosis, fractures were found to occur at 11.02%. Wrist fracture was the most frequent, affecting 4.52% of the patients, with a significantly different prevalence among men and women (P<0.001). The overall EQ-5D index score was 0.84±0.01 among patients with osteoporosis. With the exception of cancer, the EQ-5D index score were significantly lower for those having osteoarthritis, rheumatoid arthritis, hypertension, diabetes, chronic obstructive pulmonary disease and cardiovascular events compared to those without the related diseases.
CONCLUSIONS
We found that low health utility was associated with previous spine fracture and comorbidities in patients with osteoporosis. In particular, the number of fracture experiences greatly deteriorated the HRQOL in patients with osteoporosis. Thus, prevention of secondary fractures and chronic care model for comorbidities should be a priority for osteoporosis management in order to improve HRQOL.

Keyword

Comorbidity; Fractures bone; Osteoporosis; Quality of life

MeSH Terms

Absorptiometry, Photon
Arthritis, Rheumatoid
Bone Density
Bone Diseases, Metabolic
Comorbidity*
Female
Humans
Hypertension
Male
Nutrition Surveys
Osteoarthritis
Osteoporosis*
Prevalence
Pulmonary Disease, Chronic Obstructive
Quality of Life*
Spine
World Health Organization
Wrist

Figure

  • Fig. 1 Health-related quality of life scores in accordance with fracture history and comorbidity. (A) EuroQol five-dimensional questionnaire (EQ-5D) and fracture sites. (B) EQ-5D and comorbidities. OP, osteoporosis; OA, osteoarthritis; RA, rheumatoid arthritis; HTN, hypertension; DM, diabetes mellitus; COPD, chronic obstructive pulmonary disease; CV events, cardiovascular events.


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Prevalence of Osteoporosis in Korean Patients with Chronic Obstructive Pulmonary Disease and Their Health-related Quality of Life According to the Korea National Health and Nutrition Examination Survey 2008–2011
Sang Hee Lee, Hye-Young Kwon
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Trends in the Diagnosis of Osteoporosis in Patients with Distal Radius Fractures Based on a National Claims Database
Dae Geun Kim, Gi-Won Seo, Hye-Won Nam
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