#47 The Impact of Different Health Dimensions on Overall Quality of Life Related to Kyphoplasty and Non-surgical Management

General Session: Best Papers Session 2

Presented by: D. Wardlaw

Author(s):

D. Wardlaw (1)

(1) NHs Grampian, Orthopaedics, Stonehaven, United Kingdom

Abstract

Introduction: The acute back pain that arises in relation to vertebral fractures has traditionally been viewed as the most important driver for the health-related quality of life decrement associated with the fracture. The objective of this study was to quantify the impact of different health dimensions on the overall quality of life using the patient-reported outcome measurements (PROMs) collected in the Fracture Reduction Evaluation (FREE) trial.

Methods: The analysis was based on the patients included in the two-year long randomised controlled FREE-trial that studied the efficacy and safety of balloon kyphoplasty (BKP) compared to non-surgical management (NSM). The PROMs included in the FREE-trial were EQ-5D, SF-36, VAS-pain and the Roland-Morris Disability Questionnaire (RMDQ). The health dimensional contribution to the overall quality of life improvements was analysed by isolating the impact of each dimension on quality of life in the SF-36 and EQ-5D, respectively. A correlation analysis of the quality of life improvement was performed to investigate the relationships between the four instruments.

Results: Changes in pain explained 60% of the QALY gained in BKP vs. NSM followed by mobility, self-care and usual activities (EQ-5D dimensions). Health dimensions capturing the mental state did not seem to be an important factor for the QALY gained. The SF-36 dimensional analysis showed similar results. The correlation analysis showed that the correlation of VAS-pain, RMDQ and QALY improvement were fairly weak.

Conclusions: Changes in the pain dimension of health are the most important driver for overall quality of life in patients treated with BKP or NSM. However, ignoring the impact of other dimensions would lead to an underestimation of the actual improvement in overall quality of life.