Effects of Chronic Comorbidities on the Health-Related Quality of Life among Older Patients after Falls in Vietnamese Hospitals

Although comorbidities are prevalent in older people experiencing falls, there is a lack of studies examining their influence on health-related quality of life (HRQOL) in this population. This study examines the prevalence of comorbidities and associations between comorbidities and HRQOL in older patients after falls in Vietnamese hospitals. A cross-sectional design was employed among 405 older patients admitted to seven hospitals due to fall injuries in Thai Binh province, Vietnam. The EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) was used to measure HRQOL. Socio-demographic characteristics were collected using a structured questionnaire, while comorbidities and other clinical characteristics were examined by physicians and extracted from medical records. Multivariate Tobit regression was used to determine the associations between comorbidities and HRQOL. Among 405 patients, 75.6% had comorbidities, of which hypertension and osteoarthritis were the most common. Lumbar spine/cervical spine diseases (Coefficient (Coef.) = −0.10; 95%CI = −0.18; 0.03) and stroke (Coef. = −0.36; 95%CI = −0.61; −0.10) were found to be associated with a significantly decreased EQ-5D index. Participants with three comorbidities had EQ-5D indexes 0.20 points lower (Coef. = −0.20; 95%CI = −0.31; −0.09) in comparison with those without comorbidities. This study underlined a significantly high proportion of comorbidities in older patients hospitalized due to fall injuries in Vietnam. In addition, the existence of comorbidities was associated with deteriorating HRQOL. Frequent monitoring and screening comorbidities are critical to determining which individuals are most in need of HRQOL enhancement.

[1]  G. H. Ha,et al.  Fear of Falling among Older Patients Admitted to Hospital after Falls in Vietnam: Prevalence, Associated Factors and Correlation with Impaired Health-Related Quality of Life , 2020, International journal of environmental research and public health.

[2]  H. Minh,et al.  An EQ-5D-5L Value Set for Vietnam , 2020, Quality of Life Research.

[3]  B. Tran,et al.  Impact of Comorbid Chronic Conditions to Quality of Life among Elderly Patients with Diabetes Mellitus in Vietnam , 2019, International journal of environmental research and public health.

[4]  H. Nguyen,et al.  Effects of Different Comorbidities on Health-Related Quality of Life among Respiratory Patients in Vietnam , 2019, Journal of clinical medicine.

[5]  L. H. Nguyen,et al.  Health-Related Quality of Life Impairment among Patients with Different Skin Diseases in Vietnam: A Cross-Sectional Study , 2019, International journal of environmental research and public health.

[6]  J. Rusted,et al.  The impact of co-morbidity on the quality of life of people with dementia: findings from the IDEAL study , 2018, Age and Ageing.

[7]  U. Lindemann,et al.  Fact sheets , 2018, A Practical Guide to Bio-inspired Design.

[8]  Brendan Mulhern,et al.  Valuing health‐related quality of life: An EQ‐5D‐5L value set for England , 2017, Health economics.

[9]  Ju Hyun Lee,et al.  The elderly and falls: Factors associated with quality of life A cross-sectional study using large-scale national data in Korea. , 2017, Archives of gerontology and geriatrics.

[10]  L. H. Nguyen,et al.  Quality of life profile of general Vietnamese population using EQ-5D-5L , 2017, Health and Quality of Life Outcomes.

[11]  Dvora Kirshenbom,et al.  Older Age, Comorbid Illnesses, and Injury Severity Affect Immediate Outcome in Elderly Trauma Patients , 2017, Journal of emergencies, trauma, and shock.

[12]  L. H. Nguyen,et al.  Quality of life and healthcare service utilization among methadone maintenance patients in a mountainous area of Northern Vietnam , 2017, Health and Quality of Life Outcomes.

[13]  Yuan Gao,et al.  Risk Factors for In-Hospital Complications of Fall-Related Fractures among Older Chinese: A Retrospective Study , 2016, BioMed research international.

[14]  Bruce Guthrie,et al.  Clinical assessment and management of multimorbidity: summary of NICE guidance , 2016, British Medical Journal.

[15]  M. Mascalchi,et al.  Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease , 2016, International journal of chronic obstructive pulmonary disease.

[16]  L. H. Nguyen,et al.  Health status and health service utilization in remote and mountainous areas in Vietnam , 2016, Health and Quality of Life Outcomes.

[17]  A. Schols,et al.  Cachexia in chronic obstructive pulmonary disease: new insights and therapeutic perspective , 2015, Journal of cachexia, sarcopenia and muscle.

[18]  Ziad Obermeyer,et al.  Frequency of ED revisits and death among older adults after a fall. , 2015, The American journal of emergency medicine.

[19]  R. Jakes,et al.  The prevalence and patient characteristics of chronic obstructive pulmonary disease in non‐smokers in Vietnam and Indonesia: An observational survey , 2015, Respirology.

[20]  M. Baccarani,et al.  The impact of comorbidity on health-related quality of life in elderly patients with chronic myeloid leukemia , 2015, Annals of Hematology.

[21]  C. Orces Prevalence and Determinants of Fall-Related Injuries among Older Adults in Ecuador , 2014, Current gerontology and geriatrics research.

[22]  P. Martínez-Martín,et al.  Comorbidity, health status, and quality of life in institutionalized older people with and without dementia , 2013, International Psychogeriatrics.

[23]  S. Sen,et al.  Epidemiology of falls and osteoporotic fractures: a systematic review , 2012, ClinicoEconomics and outcomes research : CEOR.

[24]  B. Tran,et al.  Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients , 2012, Health and Quality of Life Outcomes.

[25]  Sarah E Lamb,et al.  Interventions for preventing falls in older people living in the community. , 2012, The Cochrane database of systematic reviews.

[26]  S. Wyke,et al.  Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study , 2012, The Lancet.

[27]  C. Finch,et al.  Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: A cluster analysis , 2011, BMC geriatrics.

[28]  R. Holle,et al.  Multimorbidity and health-related quality of life in the older population: results from the German KORA-Age study , 2011, Health and quality of life outcomes.

[29]  C. Finch,et al.  Relative survival after hospitalisation for hip fracture in older people in New South Wales, Australia , 2009, Osteoporosis International.

[30]  M. Happich,et al.  The quality of life and economic burden of neuropathy in diabetic patients in Germany in 2002--results from the Diabetic Microvascular Complications (DIMICO) study. , 2008, Diabetes research and clinical practice.

[31]  S. Farchi,et al.  Mortality in elderly injured patients: the role of comorbidities , 2008, International journal of injury control and safety promotion.

[32]  E. Wouters,et al.  Body composition and mortality in chronic obstructive pulmonary disease. , 2005, The American journal of clinical nutrition.

[33]  D. Wennberg,et al.  Epidemiology and Short‐Term Outcomes of Injured Medicare Patients , 2004, Journal of the American Geriatrics Society.

[34]  R. Ruchinskas,et al.  Clinical Prediction of Falls in the Elderly , 2003, American journal of physical medicine & rehabilitation.

[35]  R. Cumming,et al.  Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[36]  Valuing health-related quality of life , 2000 .

[37]  F. Landi,et al.  The interaction between age and comorbidity contributes to predicting the mortality of geriatric patients in the acute‐care hospital , 1997, Journal of internal medicine.

[38]  C. Mulrow,et al.  The Relationship between Disease and Function and Perceived Health in Very Frail Elders , 1994, Journal of the American Geriatrics Society.

[39]  M. Borrie,et al.  Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. , 1990, Age and ageing.