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Background <p>Hip fractures remain a serious threat, particularly among the elderly. Characterizing longitudinal patterns of quality of life (QoL) is important to understand recovery after hip fracture. Identifying subgroups with similar trajectories can help design tailored rehabilitation strategies. This study aimed to investigate the trajectories of QoL over one year following hip fracture surgery and to identify factors associated with each trajectory class.</p> Methods <p>This longitudinal study utilized a hip fracture registry database from a single medical center. QoL was assessed using the EuroQoL 5-dimension 3-level (EQ-5D-3L) questionnaire at admission, 6 months, and 1 year following hip fracture surgery. Growth mixture modelling was applied to identify subgroups of patients experiencing different trajectories of QoL. Baseline characteristics were compared between groups, and multivariate multinomial logistic regression was used to examine factors associated with trajectory group membership.</p> Results <p>Three hundred and eighty-two patients with hip fracture (mean age 80.2; 71.3% female) experienced four distinct QoL trajectories after surgery that were identified: the <i>consistently high QoL</i> group (60.47%) maintained near-optimal QoL throughout follow-up, the <i>partially declined then stable</i> group (21.99%) showed a moderate drop at 6 months with stabilization by 1 year, the <i>notably decreased QoL</i> group (12.83%) demonstrated a steep and persistent decline, representing the poorest recovery, and the <i>recovered Qol</i> group (4.71%) started with the lowest baseline QoL but showed continuous improvement over one year. Multivariate multinomial regression showed that osteosarcopenia, a lower pre-fracture EQ-5D-3L utility score, and poorer activity of daily living predicted a <i>notably decreased QoL</i> trajectory, while older age and worse cognition predicted a <i>partially declined then stable</i> trajectory. No baseline covariates significantly predicted the recovered trajectory.</p> Conclusion <p>Four QoL trajectories within one year following hip fracture surgery in elderly patients were explored. Age, comorbidity burden, musculoskeletal health, cognitive status, baseline QoL, and functional independence were significantly associated with trajectory membership. Routine assessment of these factors can help guide personalized management to help maintain QoL and prevent further decline.</p>

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Quality of life trajectories following geriatric hip fracture surgery: a growth mixture modelling approach

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月17日

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  • Tu Thai Bao Nguyen,
  • Quang Son Tran,
  • Thanh Tan Nguyen,
  • Lien-Chen Wu,
  • Yi-Jie Kuo,
  • Yu-Pin Chen

摘要

Background

Hip fractures remain a serious threat, particularly among the elderly. Characterizing longitudinal patterns of quality of life (QoL) is important to understand recovery after hip fracture. Identifying subgroups with similar trajectories can help design tailored rehabilitation strategies. This study aimed to investigate the trajectories of QoL over one year following hip fracture surgery and to identify factors associated with each trajectory class.

Methods

This longitudinal study utilized a hip fracture registry database from a single medical center. QoL was assessed using the EuroQoL 5-dimension 3-level (EQ-5D-3L) questionnaire at admission, 6 months, and 1 year following hip fracture surgery. Growth mixture modelling was applied to identify subgroups of patients experiencing different trajectories of QoL. Baseline characteristics were compared between groups, and multivariate multinomial logistic regression was used to examine factors associated with trajectory group membership.

Results

Three hundred and eighty-two patients with hip fracture (mean age 80.2; 71.3% female) experienced four distinct QoL trajectories after surgery that were identified: the consistently high QoL group (60.47%) maintained near-optimal QoL throughout follow-up, the partially declined then stable group (21.99%) showed a moderate drop at 6 months with stabilization by 1 year, the notably decreased QoL group (12.83%) demonstrated a steep and persistent decline, representing the poorest recovery, and the recovered Qol group (4.71%) started with the lowest baseline QoL but showed continuous improvement over one year. Multivariate multinomial regression showed that osteosarcopenia, a lower pre-fracture EQ-5D-3L utility score, and poorer activity of daily living predicted a notably decreased QoL trajectory, while older age and worse cognition predicted a partially declined then stable trajectory. No baseline covariates significantly predicted the recovered trajectory.

Conclusion

Four QoL trajectories within one year following hip fracture surgery in elderly patients were explored. Age, comorbidity burden, musculoskeletal health, cognitive status, baseline QoL, and functional independence were significantly associated with trajectory membership. Routine assessment of these factors can help guide personalized management to help maintain QoL and prevent further decline.