Obesity, health-care utilization, and health-related quality of life after fracture in postmenopausal women: Global Longitudinal Study of Osteoporosis in Women (GLOW).
Fractures may be associated with higher morbidity in obese postmenopausal women than in nonobese women. We compared health-care utilization, functional status, and health-related quality of life (HRQL) in obese, nonobese, and underweight women with fractures. Information from the GLOW study, started in 2006, was collected at baseline and at 1, 2, and 3 years. In this subanalysis, self-reported incident clinical fractures, health-care utilization, HRQL, and functional status were recorded and examined. Women in GLOW (n = 60,393) were aged ≥55 years, from 723 physician practices at 17 sites in 10 countries. Complete data for fracture and body mass index were available for 90 underweight, 3,270 nonobese, and 941 obese women with one or more incident clinical fractures during the 3-year follow-up. The median hospital length of stay, adjusted for age, comorbidities, and fracture type, was significantly greater in obese than nonobese women (6 vs. 5 days, p = 0.017). Physical function and vitality score were significantly worse in obese than in nonobese women, both before and after fracture; but changes after fracture were similar across groups. Use of antiosteoporosis medication was significantly lower in obese than in nonobese or underweight women. In conclusion, obese women with fracture undergo a longer period of hospitalization for treatment and have poorer functional status and HRQL than nonobese women. Whether these differences translate into higher economic costs and adverse effects on longer-term outcomes remains to be established.
Juliet E
JE
Compston
Julie
J
Flahive
Frederick H
FH
Hooven
Frederick A
FA
Anderson
Jonathan D
JD
Adachi
Steven
S
Boonen
Roland D
RD
Chapurlat
Cyrus
C
Cooper
Adolfo
A
Díez-Perez
Susan L
SL
Greenspan
Andrea Z
AZ
LaCroix
Robert
R
Lindsay
J Coen
JC
Netelenbos
Johannes
J
Pfeilschifter
Christian
C
Roux
Kenneth G
KG
Saag
Stuart
S
Silverman
Ethel S
ES
Siris
Nelson B
NB
Watts
Stephen H
SH
Gehlbach
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D058866:Osteoporotic Fractures / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D011788:Quality of Life; D011795:Surveys and Questionnaires