Evaluation of Patient-Assessed Quality of Life Questionnaires Following Operative Treatment of Pelvic Fractures

Objective: To evaluate patient-assessed quality of life (QoL) following operative treatment of acetabular fractures and pelvic ring injuries and identify differences in their assessment of QoL depending on sex and age group. Methods: The study included 75 patients, 41 who had suffered acetabular fractures and 34 pelvic ring fractures, who had been treated operatively over a 6-year period (2017-2022). Post-operative HRQOL scores were evaluated using the World Health Organization Quality of Life BREF scale (WHQOL-BREF) and RAND Short Form 36 (SF-36). Separate analyses were completed for men and women, and we compared the data between five age groups. Results: The male patients scored slightly higher in all domains than the women in the acetabular fracture group. In the ring fracture group women reported higher scores in the psychological (72.67 vs. 69.44) and social domains (81.67 vs. 77.08). The men (80%) reported more significant overall satisfaction with their health in the acetabular group compared with the women (p = 0.0306). In the SF36 analysis, for both acetabular and ring fracture groups the lowest average QoL was recorded in the physical health composite summary (PHC) with a score of 41.34 ± 9.49 and 41.21 ± 9.19, respectively. Men scored higher for all eight scales in the ring fracture and all except general health in the acetabular fracture group (p = 0.0166). For the mental health composite (MHC), men had a better mean score in both fracture groups with significant differences for between both genders for the acetabular group (p = 0.0352). For age group analysis of the SF36, in the acetabular group, the youngest age group (<40 years) reported a significant decline in their performance due to role limitations due to physical health (RP) and emotional problems (RE) compared with the oldest group (>70 years) (p = 0.0306 and p = 0.0069, respectively), similarly to the PHC (p = 0.0279). Additionally, for the overall mental health summary of the acetabular group for the five age groups, there were significant differences between the youngest age group and the oldest age group (p = 0.0372). In contrast, for the ring fracture group, the oldest age group (>70 years) scored the worst in all four scales of the physical health composite and the <40 years patients had the highest score for the physical functioning (PF) scale, with statistical significance when compared with the oldest group (85 (17.53), p = 0.01501). Additionally, the lowest mean score for the PHC was recorded in >70 years and the highest in the 61-70 years age group, with a statistical significance (p = 0.0367). Conclusions: Patients that sustain a pelvic fracture and are treated operatively are at a higher risk of deterioration in quality of life. Using both functional assessments, male patients emphasized improved quality in more spheres that was evaluated than women.