Chronic kidney disease predicts a lower probability of improvement in patient-reported experience measures among patients with fractures: a prospective multicenter cohort study
Journal
Archives of Osteoporosis
Journal Volume
13
Journal Issue
1
Pages
126
Date Issued
2018
Author(s)
Abstract
Patient-reported experience measures (PREMs) are integral component of care for fracture patients. Using a multicenter cohort, we showed that the presence of chronic kidney disease (CKD) attenuated the probability of PREM improvement in fracture patients. Assessing PREM can assist physicians in improving patients' experiences. Patients with CKD are at an increased risk of exhibiting poor PREM and developing fractures. We aimed to assess whether CKD influences the probability of PREM improvement during follow-up among patients with fractures. We prospectively enrolled patients with hip or vertebral fractures from different institutes into a fracture liaison service program. After registering clinical histories, they received a baseline PREM assessment based on EuroQol group-5 dimension content, including self-care, daily activity, and pain severity using a 5-point Likert scale. A follow-up PREM assessment was arranged 4 months later, and we evaluated whether baseline CKD was predictive of PREM improvement. Among 593 fracture patients (18% with CKD), 37.3% and 62.7% presented with hip and vertebral fractures, respectively. Self-care, daily activity, and pain severity improved after follow-up in 32%, 27%, and 43% participants; those with CKD exhibited worse self-care ability and daily activity than those without. Multivariate logistic regression analyses showed that baseline CKD was significantly associated with lower possibility of improvement in daily activity (odds ratio [OR] 0.58, p = 0.049) and pain severity (OR 0.52, p = 0.01), and an insignificant change in the possibility of improvement in self-care ability (OR 0.61, p = 0.09). The presence of CKD predicts a significantly lower probability of PREM improvement among fracture patients. An early emphasis on renal function during fracture care should be considered.
Other Subjects
alcohol; bisphosphonic acid derivative; calcium; denosumab; parathyroid hormone[1-34]; phosphate; selective estrogen receptor modulator; serum albumin; aged; albumin blood level; arm fracture; Article; body mass; calcium blood level; chronic kidney failure; chronic liver disease; cigarette smoking; clinical feature; cohort analysis; comorbidity; compression fracture; controlled clinical trial; controlled study; diabetes mellitus; European Quality of Life 5 Dimensions questionnaire; female; follow up; general condition improvement; heart disease; hip fracture; human; hypertension; major clinical study; male; multicenter study; osteoporosis; pain severity; patient reported experience measure; patient-reported outcome; phosphate blood level; priority journal; probability; prospective study; self care; spine fracture; very elderly; chronic kidney failure; clinical trial; complication; daily life activity; hip fracture; middle aged; probability; risk assessment; risk factor; spine fracture; Activities of Daily Living; Aged; Female; Hip Fractures; Humans; Male; Middle Aged; Patient Reported Outcome Measures; Probability; Prospective Studies; Renal Insufficiency, Chronic; Risk Assessment; Risk Factors; Spinal Fractures
Publisher
Springer London
Type
journal article