title: Factors associated with the course of health-related quality of life after a hip fracture.
abstract: BACKGROUND
  The number of hip fracture patients is expected to grow the forthcoming decades. Knowledge of the impact of the fracture on the lives of elderly could help us target our care. The aim of the study is to describe HRQoL (Health-Related Quality of Life) after a hip fracture and to identify factors associated with the course of HRQoL in the first postoperative year.
  
  
  METHODS
  335 surgically treated hip fracture patients (mean age 79.4 years, SD 10.7, 68 % female) were included in a prospective observational cohort. HRQoL was measured with the SF-12 Health Survey, composed of the Physical and a Mental Component Summary Score (PCS, MCS), at admission (baseline) and at 3 and 12 months postoperatively. Eleven predefined factors known to be associated with the course of HRQoL were recorded: age, gender, physical status, having a partner at admission, living in an institution, prefracture level of mobility, anemia, type of fracture and treatment, delirium during hospital stay and length of stay.
  
  
  RESULTS
  HRQoL declined between baseline and 3 months, and recovered between three and 12 months. PCS HRQoL did not recover to baseline values, MCS HRQoL did. Age younger than 80 years, ASA classification I and II, higher prefracture level of mobility, intracapsular fracture and treatment with osteosynthesis (compared to arthroplasty) were associated with greater initial decline in PCS HRQoL, none of the recorded factors were significant for decline in MCS HRQoL.
  
  
  CONCLUSIONS
  Both PCS and MCS HRQoL declined after a hip fracture and PCS did not recover to baseline values. Healthier patients may need extra care to prevent them from having a steep decline in postoperative PCS HRQoL and arthroplasty should be considered with low threshold.
authors.affiliation: Department of Orthopedic Surgery, Reinier de Graaf Group, Reinier de Graafweg 3-11, 2625, AD, Delft, The Netherlands. sophie.moerman@rdgg.nl.
authors.forename: Sophie
authors.initials: S
authors.lastname: Moerman
authors.affiliation: Centre for Orthopedic Surgery OCON, Geerdinksweg 141, 7555, DL, Hengelo, The Netherlands.
authors.forename: Anne J H
authors.initials: AJ
authors.lastname: Vochteloo
authors.affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands.
authors.forename: Wim E
authors.initials: WE
authors.lastname: Tuinebreijer
authors.affiliation: Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Centre, De Boelelaan 1117, 1007, MB, Amsterdam, The Netherlands.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Maier
authors.affiliation: Department of Orthopedic Surgery, Reinier de Graaf Group, Reinier de Graafweg 3-11, 2625, AD, Delft, The Netherlands.
authors.forename: Nina M C
authors.initials: NM
authors.lastname: Mathijssen
authors.affiliation: Department of Orthopedic Surgery Leiden University Medical Centre, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands.
authors.forename: Rob G H H
authors.initials: RG
authors.lastname: Nelissen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal; D006306:Health Surveys; D006620:Hip Fractures / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life
keywords: Function; Geriatric fracture; Hip fracture; Outcome; Quality of life; SF 12