Quality of life after hip fracture in the elderly: A systematic literature review

Charles M M Peeters; Eva Visser; Cornelis L P Van de Ree; Taco Gosens; Brenda L Den Oudsten; Jolanda De Vries

doi:10.1016/j.injury.2016.04.018

Quality of life after hip fracture in the elderly: A systematic literature review

Injury. 2016 Jul;47(7):1369-82. doi: 10.1016/j.injury.2016.04.018. Epub 2016 Apr 23.

Authors

Charles M M Peeters¹, Eva Visser², Cornelis L P Van de Ree³, Taco Gosens³, Brenda L Den Oudsten⁴, Jolanda De Vries⁵

Affiliations

¹ Department of Orthopaedics, St. Elisabeth Hospital, Tilburg, The Netherlands.
² Trauma TopCare, St. Elisabeth Hospital, Tilburg, The Netherlands.
³ Department of Orthopaedics, St. Elisabeth Hospital, Tilburg, The Netherlands; Trauma TopCare, St. Elisabeth Hospital, Tilburg, The Netherlands.
⁴ Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
⁵ Trauma TopCare, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Medical Psychology, St. Elisabeth Hospital, Tilburg, The Netherlands; Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. Electronic address: j.devries@tilburguniversity.edu.

PMID: 27178770
DOI: 10.1016/j.injury.2016.04.018

Abstract

Background: With an increasing ageing population, hip fractures have become a major public health issue in the elderly. It is important to examine the health status (HS) and health-related quality of life (HRQOL) of the elderly faced with the epidemic of hip fractures.

Objective: To provide an overview of reported HS and HRQOL in elderly patients with a hip fracture.

Design: A systematic literature search was performed in Embase, Medline, Web of Science, Scopus, CINAHL, Cochrane, PsycINFO, Pubmed, and Google Scholar in July 2014. Studies which reported the HS or HRQOL based on standardised questionnaires in patients older than 65 years with a hip fracture were considered eligible for inclusion.

Results: After inspecting the 2725 potentially eligible studies, 49 fulfilled the inclusion criteria. All included studies were randomised controlled trials or prospective cohort studies. The methodological quality of the studies was moderate. Patients' functioning on the physical, social, and emotional domains were affected after a hip fracture. The HS and HRQOL of the majority of patients recovered in the first 6 months after fracture. However, their HS did not return to prefracture level. Mental state, prefracture functioning on physical and psychosocial domains, comorbidity, female gender, nutritional status, postoperative pain, length of hospital stay, and complications were factors associated with HS or HRQOL. Treatment with total hip arthroplasty or hemi-arthroplasty provided better HS than treatment with internal fixation with displaced femoral neck fractures. Supportive psychotherapy in "low-functioning" patients, (home) rehabilitation programmes and nutritional supplementation appeared to have beneficial effects on HS.

Conclusions: Optimizing nutrition intake, (home) rehabilitation programmes, and the possibility for psychological counselling in patients with difficulties in the psychosocial dimensions would be recommended after hip fracture surgery. Besides HS questionnaires like EQ-5D and SF-36, adequate measurements like the WHOQOL-Bref or ICECAP-O are warranted in future studies regarding hip fracture surgery and postoperative treatment options.

Keywords: Elderly; Health status; Health-related quality of life; Hip fracture; Systematic review.

Publication types

Review
Systematic Review

MeSH terms

Aged
Arthroplasty, Replacement, Hip / mortality
Arthroplasty, Replacement, Hip / psychology*
Arthroplasty, Replacement, Hip / rehabilitation
Hip Fractures / mortality
Hip Fractures / psychology*
Hip Fractures / surgery
Humans
Netherlands / epidemiology
Postoperative Period
Quality of Life*
Survival Analysis
Treatment Outcome