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
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Article info
Publication history
Published online: April 22, 2016
Accepted:
April 17,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
