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Osteoporos Int. 2015 Jun;26(6):1781-90. doi: 10.1007/s00198-015-3088-z. Epub 2015 Mar 20.

Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS).

Author information

Deakin Health Economics, Population Health Strategic Research Centre, Deakin University, Burwood, VIC, Australia.
Deakin Health Economics, Population Health Strategic Research Centre, Deakin University, Burwood, VIC, Australia.
LIME/MMC, Karolinska Institutet, Solna, Sweden.
Australian Institute of Musculoskeletal Science, Department of Medicine, The University of Melbourne-Western Health, Melbourne, VIC, Australia.
Rural Clinical School, The University of Queensland, Toowoomba, QLD, Australia.
School of Medicine, Deakin University, Geelong, VIC, Australia.
Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC, Australia.
Sir Charles Gairdner Hospital, Perth, WA, Australia.
Institute of Bone and Joint Research, University of Sydney-Royal North Shore Hospital, Sydney, NSW, Australia.
Menzies Research Institute Tasmania, University of Tasmania, Tasmania, TAS, Australia.
Ageing Bone Research Program, Sydney Medical School, Nepean Hospital, University of Sydney, Sydney, NSW, Australia.
Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.
Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia.


We investigated change in health-related quality of life due to fracture in Australian adults aged over 50 years. Fractures reduce quality of life with the loss sustained at least over 12 months. At a population level, the loss was equivalent to 65 days in full health per fracture.


We aimed to quantify the change in health-related quality of life (HRQoL) that occurred as a consequence of a fracture using the EQ-5D-3 L questionnaire.


Adults aged ≥50 years with a low to moderate energy fracture were recruited from eight study centres across Australia. This prospective study included an 18-month follow-up of participants recruited within 2 weeks of a fracture (hip, wrist, humerus, vertebral and ankle). Information collected at baseline and 4, 12 and 18 months included characteristics of participants such as income level, education and prior fracture status. At 12 months post-fracture, the cumulative loss of quality of life was estimated using multivariate regression analysis to identify the predictors of HRQoL loss.


Mean HRQoL for all participants before fracture was 0.86, with wrist fracture having the highest pre-fracture HRQoL (0.90), while vertebral fracture had the lowest (0.80). HRQoL declined to 0.42 in the immediate post-fracture period. Only participants with a wrist, humerus or ankle fracture returned to their pre-fracture HRQoL after 18 months. An increased loss of HRQoL over 12 months was associated with HRQoL prior to the fracture, hospitalisation, education and fracture site. The multiple regression explained 30 % of the variation in the cumulative HRQoL loss at 12 months post-fracture for all fractures.


Low to moderate energy fractures reduce HRQoL, and this loss is sustained for at least 12 months or, in the case of hip and spine fractures, at least 18 months. At a population level, this represents an average loss of 65 days in full health per fragility fracture. This significant burden reinforces the need for cost-effective fracture prevention strategies.


Ankle; Fracture; Health-related quality of life; Humeral; Prospective

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