title: The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study.
abstract: Using prospective data from the Canadian Multicentre Osteoporosis Study (CaMos), we compared health utilities index (HUI) scores after 5 years of follow-up among participants (50 years and older) with and without incident clinical fractures. Incident fractures had a negative impact on HUI scores over time.
  
  
  BACKGROUND
  This study examined change in health-related quality of life (HRQL) in those with and without incident clinical fractures as measured by the HUI.
  
  
  METHODS
  The study cohort was 4,820 women and 1,783 men (50 years and older) from the CaMos. The HUI was administered at baseline and year 5. Participants were sub-divided into incident fracture groups (hip, rib, spine, forearm, pelvis, other) and were compared with those without these fractures. The effects of both time and fracture type on HUI scores were examined in multivariable regression analyses.
  
  
  RESULTS
  Men and women with hip fractures, compared to those without, had lower HUI measures that ranged from -0.05 to -0.25. Both women and men with spine fractures had significant deficits on the pain attributes (-0.07 to -0.12). In women, self-care (-0.06), mobility and ambulation (-0.05) were also negatively impacted. Women with rib fractures had deficits similar to women with spine fractures, and these effects persisted over time. In men, rib fractures did not significantly affect HUI scores. Pelvic and forearm fractures did not substantially influence HUI scores.
  
  
  CONCLUSIONS
  The HUI was a sensitive measure of HRQL change over time. These results will inform economic analyses evaluating osteoporosis therapies.
authors.affiliation: McMaster University, Hamilton Health Sciences-Chedoke Site, Hamilton, ON, Canada. papaioannou@hhsc.ca
authors.forename: A
authors.initials: A
authors.lastname: Papaioannou
authors.forename: C C
authors.initials: CC
authors.lastname: Kennedy
authors.forename: G
authors.initials: G
authors.lastname: Ioannidis
authors.forename: A
authors.initials: A
authors.lastname: Sawka
authors.forename: W M
authors.initials: WM
authors.lastname: Hopman
authors.forename: L
authors.initials: L
authors.lastname: Pickard
authors.forename: J P
authors.initials: JP
authors.lastname: Brown
authors.forename: R G
authors.initials: RG
authors.lastname: Josse
authors.forename: S
authors.initials: S
authors.lastname: Kaiser
authors.forename: T
authors.initials: T
authors.lastname: Anastassiades
authors.forename: D
authors.initials: D
authors.lastname: Goltzman
authors.forename: M
authors.initials: M
authors.lastname: Papadimitropoulos
authors.forename: A
authors.initials: A
authors.lastname: Tenenhouse
authors.forename: J C
authors.initials: JC
authors.lastname: Prior
authors.forename: W P
authors.initials: WP
authors.lastname: Olszynski
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002170:Canada; D005260:Female; D005543:Forearm Injuries / Q000209:etiology / Q000534:rehabilitation; D050723:Fractures, Bone / Q000209:etiology / Q000534:rehabilitation*; D006304:Health Status; D006305:Health Status Indicators; D006620:Hip Fractures / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D010384:Pelvic Bones / Q000293:injuries; D011446:Prospective Studies; D011788:Quality of Life; D012253:Rib Fractures / Q000209:etiology / Q000534:rehabilitation; D016103:Spinal Fractures / Q000209:etiology / Q000534:rehabilitation; D013997:Time Factors