Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis

<p><strong>Purpose:</strong> To summarise and appraise evidence on the prognosis and long-term clinical and socio-economic outcomes following wrist fracture among adults aged 50 years and over.</p> <p><strong>Methods:</strong> Five databases (MEDLINE, EMBAS...

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Main Authors: Babatunde, OO, Bucknall, M, Burton, C, Forsyth, JJ, Corp, N, Gwilym, S, Paskins, Z, van der Windt, DA
Format: Journal article
Language:English
Published: Springer 2021
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author Babatunde, OO
Bucknall, M
Burton, C
Forsyth, JJ
Corp, N
Gwilym, S
Paskins, Z
van der Windt, DA
author_facet Babatunde, OO
Bucknall, M
Burton, C
Forsyth, JJ
Corp, N
Gwilym, S
Paskins, Z
van der Windt, DA
author_sort Babatunde, OO
collection OXFORD
description <p><strong>Purpose:</strong> To summarise and appraise evidence on the prognosis and long-term clinical and socio-economic outcomes following wrist fracture among adults aged 50 years and over.</p> <p><strong>Methods:</strong> Five databases (MEDLINE, EMBASE, AMED, CINAHL-P and PsycINFO) were comprehensively searched (supplemented by a grey-literature search) from inception till June 2021 for prospective/retrospective cohort studies of patients (≥50 years) with a history of wrist fracture and reporting long-term (≥6 months) outcomes. Peer study selection, data extraction and risk of bias assessment were conducted. A random effects meta-analysis was used to summarise estimates of pain and function outcomes.</p> <p><strong>Results:</strong> 78 studies (n=688,041 patients) were included. Patients report persistent moderate to severe pain (range: 7.5%-62%) and functional limitations (range: 5.5-78%) up to 12-months or later after wrist fracture. Mean Patient-Rated Wrist Evaluation (PRWE) score for pain and function (9 studies, n=1759 patients) was 15.23 (95%CI 12.77, 17.69) at 6-months to 13-years follow-up. Mean disabilities of the arm, shoulder and hand (DASH) score (9 studies, n=1346 patients) was 13.82 (95%CI 12.71, 14.93)( at 6- to 17-months follow-up. A 10-20% increase in healthcare encounters in the first 12-months after fracture was observed. Twelve prognostic factors were associated with poor long-term outcomes.</p> <p><strong>Conclusion:</strong> Evidence shows that a high proportion of people aged over 50 years with wrist fracture experience pain and functional limitation >6months after fracture. This is associated with increased healthcare costs, and reduced quality of life. Exploratory evidence was found for several candidate prognostic factors. Their predictive performance needs to be investigated further.</p>
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spelling oxford-uuid:1b8c60a7-735d-46e7-bd71-fcf18e0eb5032023-04-20T09:34:47ZLong-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1b8c60a7-735d-46e7-bd71-fcf18e0eb503EnglishSymplectic ElementsSpringer2021Babatunde, OOBucknall, MBurton, CForsyth, JJCorp, NGwilym, SPaskins, Zvan der Windt, DA<p><strong>Purpose:</strong> To summarise and appraise evidence on the prognosis and long-term clinical and socio-economic outcomes following wrist fracture among adults aged 50 years and over.</p> <p><strong>Methods:</strong> Five databases (MEDLINE, EMBASE, AMED, CINAHL-P and PsycINFO) were comprehensively searched (supplemented by a grey-literature search) from inception till June 2021 for prospective/retrospective cohort studies of patients (≥50 years) with a history of wrist fracture and reporting long-term (≥6 months) outcomes. Peer study selection, data extraction and risk of bias assessment were conducted. A random effects meta-analysis was used to summarise estimates of pain and function outcomes.</p> <p><strong>Results:</strong> 78 studies (n=688,041 patients) were included. Patients report persistent moderate to severe pain (range: 7.5%-62%) and functional limitations (range: 5.5-78%) up to 12-months or later after wrist fracture. Mean Patient-Rated Wrist Evaluation (PRWE) score for pain and function (9 studies, n=1759 patients) was 15.23 (95%CI 12.77, 17.69) at 6-months to 13-years follow-up. Mean disabilities of the arm, shoulder and hand (DASH) score (9 studies, n=1346 patients) was 13.82 (95%CI 12.71, 14.93)( at 6- to 17-months follow-up. A 10-20% increase in healthcare encounters in the first 12-months after fracture was observed. Twelve prognostic factors were associated with poor long-term outcomes.</p> <p><strong>Conclusion:</strong> Evidence shows that a high proportion of people aged over 50 years with wrist fracture experience pain and functional limitation >6months after fracture. This is associated with increased healthcare costs, and reduced quality of life. Exploratory evidence was found for several candidate prognostic factors. Their predictive performance needs to be investigated further.</p>
spellingShingle Babatunde, OO
Bucknall, M
Burton, C
Forsyth, JJ
Corp, N
Gwilym, S
Paskins, Z
van der Windt, DA
Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis
title Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis
title_full Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis
title_fullStr Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis
title_full_unstemmed Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis
title_short Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis
title_sort long term clinical and socio economic outcomes following wrist fracture a systematic review and meta analysis
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