Associations among health-related quality of life, mental resilience and social support in patients early after surgery for osteoporotic vertebral compression fractures: a longitudinal study

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OBJECTIVE: This study aims to explore the profile of health-related quality of life (HRQoL) of postoperative osteoporotic vertebral compression fracture (OVCF) patients through a longitudinal investigation, especially in the early postoperative phase, discern the effect of mental resilience and social support on postoperative HRQoL and further explore the mechanisms by which mental resilience exerts influences on HRQoL. DESIGN: This longitudinal observational study was conducted to examine the HRQoL of OVCF patients during the early postoperative period. Data collection occurred at three distinct time points: baseline assessment on postoperative day 1 (T1), followed by subsequent evaluations at 1 month (T2) and 3 months (T3) postsurgery. SETTING: Zhoupu Hospital, in Shanghai, China. PARTICIPANTS: A total of 155 postoperative OVCF patients completed the baseline survey, with 150 and 140 participants completing the follow-up at T2 and T3. OUTCOME MEASURES: Primary end-point variables were HRQoL, mental resilience and social support. Secondary end-point outcomes included demographic data and disease-related information. RESULTS: The baseline data indicated that the average age of participants was 69.6 years, ranging from 53 to 92 years, with females accounting for 69.0%. There was no significant difference in demographic characteristics, such as age, gender and other factors, between the follow-up and the lost (p>0.05). Although the level of HRQoL, mental resilience and social support still remain at relatively lower levels at three separate times, they gradually elevated with time. Both mental resilience (r=0.293, p<0.01) and social support (r=0.257, p<0.01) demonstrated significant positive correlations with HRQoL. Multiple linear regression analysis at T3 identified smoking history (β=-0.137, p<0.001), gender (β=-0.154, p<0.001) and diabetes (β=0.126, p=0.001) as independent factors for postoperative HRQoL. Longitudinal mediation analysis suggests that social support exerted an indirect effect on HRQoL through mental resilience (β=1.017, p<0.001). CONCLUSIONS: Mental resilience and social support are strongly intertwined with HRQoL of OVCF patients after surgery in the early postoperative stage. Notably, social support exerts its beneficial effects on HRQoL through enhanced mental resilience in this critical postoperative period. Targeted interventions should be implemented to optimise social support networks and cultivate psychological resilience, which may substantially improve postoperative HRQoL outcomes.

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