Long-term health related quality of life after pelvic fractures: Follow-up on the Brabant Injury Outcome Surveillance (BIOS) study.

Abstract

Pelvic fractures, including pelvic ring fractures and acetabular fractures, are relatively rare but often severe and associated with a significant physical and societal burden. Outcome data on long-term health related quality of life (HRQoL) following pelvic fractures remains scarce. This study aimed to evaluate long-term HRQoL outcomes in a patient cohort with pelvic fractures up to 8 years post injury. A long-term prospective follow-up study of the Brabant Injury Outcome Surveillance (BIOS) pelvic fractures cohort was performed. HRQoL was assessed at 1, 2, and 8 years post injury using the EQ-5D-3L among adult patients (≥ 18 years) with pelvic fractures. Longitudinal trajectories of HRQoL and subgroup differences by sex, age, and trauma mechanism over time were assessed using linear mixed models. Of the 184 included patients, the response rate was 86% (n = 159) at 1 year follow-up, 63% (n = 115) at 2 years follow-up, and 34% (n = 63) at 8 years follow-up. The mean EQ-5D-3L VAS score at 1 year follow-up was 74.8 (SD 16.2) and improved over time to a mean score of 78.0 (SD 16.6) at 2 years follow-up. At 8 years follow-up the mean EQ-5D-3L VAS has decreased to 72.7 (SD 20.4). The mean EQ-5D-3L index score was 0.80 (SD 0.24) at 1 year follow up. At 2 years follow-up, the mean EQ-5D-3L index score increased to 0.81 (SD 0.21) and plateaued thereafter with a mean score of 0.81 (SD 0.24) at 8 years follow-up. Pain/discomfort remained the most affected domain with almost half of patients reporting problems at 8 years follow-up. Female sex, higher ISS, and pre-injury health complaints were identified as significant risk factors for long-term limitations across multiple domains. Although improvements in HRQoL were observed over time, persistent complaints and decreased HRQoL were reported at 8 years follow-up. These findings underscore the importance of monitoring HRQoL and tailored interventions to manage the ongoing impact of pelvic fractures on HRQoL.