Mortality after distal radius fracture in men and women aged 50 years and older in southern Norway

Increased mortality rates in patients sustaining hip and vertebral fractures are well documented; however in distal radius fracture patients the results are conflicting. The aim of this study was to examine short- and long-term mortality in distal radius fracture patient in comparison with the background population. Patients aged ≥50 years with distal radius fracture living in Southern Norway who suffered a fracture in the two year period 2004 and 2005 were included in the study. The mortality risk of the standard Norwegian population was used to calculate the standardized mortality ratio (SMR). The number of distal radius fractures was 883 (166 men and 717 women). Mean age was 69 years (men 65 years and women 70 years). After one year the overall mortality rate was 3.4% (men 5.4% and women 2.9%) and after five years 4.6% (men 4.0% and women 4.8%). The SMR for men and women compared to the Norwegian population for the first year was 1.6 (95% confidence interval (CI): 0.6, 2.7) and 0.9 (95% CI: 0.4, 1.2), respectively, and after five years 1.7 (95% CI: 0.3, 3.0) and 2.0 (95% CI: 1.2, 2.7). Stratified on age groups (50–70 and >70 years) an increased SMR was only seen in female patients aged >70 years five years after the fracture (SMR: 1.9, 95% CI: 1.1, 2.6). In conclusion, increased SMR was found in female patients aged >70 years five years after the distal radius fracture, but not in men or in women younger than 70 years.© 2014 Øyen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Hand bone loss as an outcome measure in established rheumatoid arthritis: 2-year observational study comparing cortical and total bone loss

The aim of this 2-year longitudinal observational study was to explore hand bone loss as a disease outcome measure in established rheumatoid arthritis (RA)

Perceived effects of health status on sexual activity in women and men older than 50

Published version of an article from the journal: Health and Quality of Life Outcomes. Also available from the publisher: http://dx.doi.org/10.1186/1477-7525-12-43Background Sexual activity and enjoyment are considered to be important components of quality of life (QOL) for adults of all ages. However, limited data are available on the effects of health status on sexual activity in women and men older than 50 years. Thus, our aim was to explore the perceived effects of health status on sexual activity in women and men older than 50 years. Methods For this purpose we used data from an age and gender matched control study initially designed to study QOL in patients with low-energy wrist fracture. We investigated patients with wrist fractures older than 50 years (n = 181), as well as age- and gender-matched controls (n = 226), who participated in the QOL study. There were minimal differences between patients and controls, thus the groups were pooled (mean age 67 years (8 SD)). Health-related quality of life (HRQOL) was assessed using SF-36 and 15D, and the global quality of life using the Quality of Life Scale (QOLS). To assess perceived effects of health status on sexual activity we used the question on sexuality from the 15D questionnaires. Group comparisons and logistic regression analyses were conducted. Results The 15D question on sexuality was not answered by 25% of the participants. Health status having a large negative effect on sexual activity was reported by only 13% of the participants. In the multivariate analyses a large negative effect of health status on sexual activity was associated with higher age (60–69 years: OR = 5.7, 95% CI = 1.62–29.2; 70–79 years: OR = 3.60, 95% CI = 0.94–13.9; ≥80 years: OR = 9.04, 95% CI = 1.29–63.4), male gender (OR = 10.8, 95% CI = 3.01–38.9), weight (OR = 1.03, 95% CI = 1.00–1.07), low SF-36 PCS score (OR = 0.88, 95% CI = 0.37–0.93) and a low SF-36 MCS score (OR = 0.92, 95% CI = 0.88–0.96). Conclusion Only a small proportion of the participants reported their health status to have a large negative effect on sexual activity. Furthermore, health status having a negative effect on sexual activity was associated with decreased HRQOL. Insights into this important topic may increase our awareness as health care workers and help us to address this aspect of QOL in this age group. Keywords: Health status; Sexual activity; Quality of life; Elderl

Lyme arthritis in Southern Norway - an endemic area for Lyme Borreliosis

Background: Despite Southern Norway is an endemic area for Lyme borreliosis there is a lack of data on Lyme arthritis (LA). In the literature controversies exist if acute LA can develop into chronic arthritis. Our objective was to identify and characterize patients with LA in Southern Norway and explore disease course after antibiotic treatment.Methods: Patients aged 20 years or older with arthritis and a positive serology for Borrelia burgdorferi infection (IgG and/or IgM) suspected of having LA were consecutively recruited either from general practitioners or from hospital departments.Results: From January 2007 to December 2010 a total of 27 patients were assessed. Mean (range) age was 56 years (41-80) and mean symptom duration prior to inclusion was 11.2 weeks (1 day - 2 years). Definite LA was diagnosed in 16 patients, probable LA in 5 patients and 6 patients were concluded to have other arthritis disorders. Among the 21 LA patients 20 had mono-arthritis (knee 18, ankle 2) and 1 had polyarthritis.All LA patients responded favourable to antibiotic treatment and none of the patients developed chronic arthritis after long term follow up, not even in LA patients who had intraarticular glucocorticosteroid (GC) injection prior to antibiotic treatment.Conclusions: Our data shows that LA in Southern Norway is a benign disease which successfully can be treated with antibiotics even in patients treated with GC prior to antibiotics

Comparing 15D and SF-6D performance in fragility wrist and hip fracture patients in a two-year follow-up case-control study

Accepted version of an article in the journal:Value in Health. Published available from Elsevier on Science Direct: http://dx.doi.org/10.1016/j.jval.2012.08.2200Objectives To examine and compare the two utility and health-related quality-of-life (HRQOL) measures 15D and (SF-6D) in fragility wrist and hip fracture patients and controls, study the responsiveness of 15D and SF-6D, and examine the impact of these fractures on changes in 15D and SF-6D scores over 2 years. Methods A total of 152 wrist fracture patients and 164 controls and 61 hip fracture patients and 61 controls with 15D and SF-6D scores were studied. Results The mean 15D score decreased significantly in wrist fracture patients between baseline and 2-year follow-up (P=0.003). A wrist fracture was a significant predictor of a decrease in 15D scores 2 years after fracture (B=−0.016; P=0.049), along with low body mass index (B=−0.002; P=0.009). In hip fracture patients, both 15D and SF-6D scores decreased significantly (P<0.001). A hip fracture was a significant predictor of a decrease in 15D (B=−0.060; P=0.001) and SF-6D (B=−0.096; P=0.001) scores. Conclusions Our data suggest that a fragility wrist fracture has a long-term negative effect on HRQOL, but not as strong as for fragility hip fractures. 15D seems to be more responsive than SF-6D when assessing HRQOL in patients with fragility fractures

Vasculitis distribution and clinical characteristics in giant cell arteritis: a retrospective study using the new 2022 ACR/EULAR classification criteria

IntroductionGiant cell arteritis (GCA) is the most common vasculitis of the elderly. In recent years, advanced imaging has to a certain extent replaced temporal artery biopsy (TAB) to aid diagnosis in many institutions and helped to identify three major phenotypes of GCA, namely, cranial GCA (c-GCA), large-vessel non-cranial GCA (LV-GCA), and a combination of these two patterns called mixed-GCA, which all show different clinical patterns. Recent 2022 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria respect the changing conception and clinical practice during the last two decades. In this cohort study, we present vasculitis distribution and baseline characteristics using the 2022 ACR/EULAR classification criteria as well as the EULAR core data set.MethodsIn this retrospective study from Southern Norway, we identified all patients diagnosed with GCA between 2006 and 2019 in our single-center fast-track clinic (FTC). We included all patients who were examined using ultrasound (US) of cranial as well as non-cranial large vessels at diagnosis to depict vascular distribution. EULAR core data set, ACR 1990, and 2022 ACR/EULAR classification criteria were used to characterize the cohort.ResultsSeventy-seven patients were diagnosed with GCA at our institution in the aforementioned period. Seventy-one patients (92.2%) were diagnosed with the help of US and included in the further analysis. The 2022 ACR/EULAR classification criteria allocated 69 patients (97.2%), while the ACR 1990 classification criteria allocated 49 patients (69.0%) in our cohort as having GCA. Mixed-GCA was the most common type in 33 patients (46.5%). Weight loss was significantly more common in patients with large-vessel non-cranial vasculitis in LV-GCA and mixed-GCA. Headache, on the other hand, was significantly more common in patients with involvement of cranial vessels.ConclusionMixed GCA was the most common form of GCA in our cohort. In our study, the 2022 ACR/EULAR classification criteria seem to be a more useful tool compared with the old ACR 1990 classification criteria to allocate GCA patients diagnosed and treated at our US-based FTC as having GCA

Is global quality of life reduced before fracture in patients with low-energy wrist or hip fracture? A comparison with matched controls

<p>Abstract</p> <p>Background</p> <p>The aims of the study were (i) to examine global quality of life (GQOL) before fracture in patients with low-energy wrist or hip fracture compared with an age- and sex-matched control group, and (ii) to identify relationships between demographic variables, clinical fracture variables, and health- and global-focused quality of life (QOL) prior to fracture.</p> <p>Methods</p> <p>Patients with a low-energy fracture of the wrist (n = 181) or hip (n = 97) aged ≥ 50 years at a regional hospital in Norway and matched controls (n = 226) were included. The participants answered retrospectively, within two weeks after the fracture, a questionnaire on their GQOL before the fracture occurred using the Quality of Life Scale (QOLS), and health-focused QOL using the Short Form-36, physical component summary, and mental component summary scales. A broad range of clinical data including bone density was also collected. ANOVA and multiple linear regression analysis were used to analyse the data.</p> <p>Results</p> <p>Osteoporosis was identified in 59% of the hip fracture patients, 33% of the wrist fracture patients, and 16% of the controls. After adjusting GQOL scores and the three sub-dimensions for known covariates (sociodemographics, clinical fracture characteristics, and health-focused QOL), the hip patients reported significantly lower scores compared with the controls, except for the sub-dimension of personal, social, and community commitment (p = 0.096). Unadjusted and adjusted GQOL scores did not differ between the wrist fracture patients and controls. Sociodemographics (age, sex, education, marital status), clinical fracture variables (osteoporosis, falls, fracture group) and health-focused QOL explained 51.4% of the variance in the QOLS, 35.2% of the variance in relationship and marital well-being, 59.3% of the variance in health and functioning, and 24.9% of the variance of personal, social, and community commitment.</p> <p>Conclusion</p> <p>The hip fracture patients had lower GQOL before the fracture occurred than did controls, even after adjusting for known factors such as sociodemographics, clinical variables and health-focused QOL. The findings suggest that by identifying patients with low GQOL, in addition to other known risk factors for hip fracture, may raise the probability to target preventive health care activities.</p