Avaliação prospectiva da qualidade de vida relacionada a saúde em idosos com fratura do quadril por meio de um instrumento genérico - The Medical Outcome Study 36-Item Short-Form Health Survey (SF-36)

Abstract

Hip fractures occur frequently in the aged and have a considerable impact on health-related quality of life (HRQOL) of the elderly affected. This study aimed to assess the psychometric properties of the Brazilian version of the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) in elderly with hip fractures and the HRQOL of this population over 4 months following fracture. Forty five elderly (60% female) aged between 62 and 92 years (mean= 74.4; SD=8.81) answered the SF-36. Patient scores at baseline, 1 and 4 months after surgery (ou hospital discharge), were compared to 135 controls (mean age=72.3;SD=6.92), and according to fracture type (femoral neck or trochanteric). Psychometric qualities assessed were: on floor and ceiling effect, item internal consistency, internal consistency reliability, reprodutibility, discriminant validity, item discriminant validity, convergent validity, divergent validity, criterion validity, concurrent validity, construct validity and minimallyl important difference. All psychometric properties assessed were deemed adequate as a whole. Patients scores at baseline were lower (p<0.05) than the controls for vitality, mental health and social aspects domains. Similarly, patients scored lower at 4 months after surgery (p<0.05) than controls, except for the general state of health domain, and also lower at baseline, except for pain, general state of health, social aspects, mental health and vitality domains. No significant difference was observed amongst scores according to type of fracture. Brazilian version of the SF-36 demonstrated good reliability, validity and responsiveness as applied to patients with hip fracture. Independent of type of hip fracture, elderly patients presented significant compromise in their quality of life, at one and four months after hip fracture, both in physical and psychosocial aspects, while experiencing partial recovery only within the fourth month.