Quality of Life after Open Extremity Trauma (QUINTET) study: An international, multicentric, observational, cohort study of quality of life following lower extremity open fractures

Introduction: Open lower limb fractures are severe injuries with long-lasting consequences. Limited research has been conducted on the impact of these injuries on quality of life (QoL), internationally. Methods: The Quality of Life after Open Extremity Trauma (QUINTET) study was designed as an international, multicentric, observational, cohort study of patients presented with open lower limb fractures. Demographic and clinical information was collected, along with repeated validated QoL measures. Primary outcomes were SF-12 and EQ-5D-3L, and secondary outcomes were soft tissue infection, deep infection, non-union and amputation. Results: A total of 92 patients were enrolled in 8 centres, based in the UK, Spain, Chile and Sudan. The mean age at presentation was 54 years, 47 years for males and 64 years for females. Males presented a higher proportion of road traffic accidents as the underlying mechanism, whereas for females, this was the case of low-energy falls. Participant retention was 71.7% and 73.9% for the 3- and 12-month assessments, respectively. There was a substantial reduction in QoL after open fracture, which only partially recovered at 12 months. Participants recruited in the UK presented lower QoL scores compared with patients treated in Spain and Chile. Discussion: For this study, international patient recruitment proved challenging, leading to most patients being recruited in the UK. Despite this limitation, we found a statistically significant detriment in self-reported QoL, which did not recover after a year. This study highlights differences in quality-of-life outcomes from a gender and international perspective.