Comparing Frailty Status Among Clusters Identified Based on EQ-5D-5L Dimensions in Older Patients with Chronic Low Back Pain
Abstract
1. Introduction
2. Materials and Methods
2.1. Ethics and Consent
2.2. Study Population
2.3. Evaluation of HRQoL
2.4. Frailty Screening
- Fatigue: Participants receive 1 point if they report feeling that everything they did was a lot of effort for more than 3 days a week in the past week, otherwise 0 points.
- Resistance: Participants receive 1 point if they have difficulty climbing 10 stairs without assistance, otherwise 0 points.
- Ambulation: Participants receive 1 point if they report any difficulty walking around a 400 m playground track, otherwise 0 points.
- Inactivity: Participants receive 1 point if they do not engage in moderate or vigorous physical activity in the past 7 days, otherwise 0 points.
- Unintentional weight loss: Participants receive 1 point if they lost 4.5 kg or more unintentionally in the past year, otherwise 0 points.
2.5. Patient Demographics and Clinical Data Measurements
2.6. Statistical Analysis
2.7. Cluster Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
LBP | Low back pain |
HRQoL | Health-related quality of life |
EQ-VAS | EQ Visual Analogue Scale |
BMI | Body mass index |
NRS | Numeric Rating Scale |
SD | Standard deviation |
References
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Variables | Total (n = 837) |
---|---|
Patient characteristics | |
Age, years | 72.01 ± 7.14 (60–96) |
Female sex, n | 562 (67.1) |
BMI, kg/m2 | 22.89 (20.81; 25.18) |
Comorbid medical disease, n | |
Hypertension | 251 (30.0) |
Diabetes mellitus | 146 (17.4) |
Cancer | 130 (15.5) |
Mental health problems | 107 (12.8) |
Osteopenia/osteoporosis | 104 (12.4) |
Spine surgery history, n | 197 (23.5) |
Pain-related data | |
Baseline pain score | |
Mild (NRS 1–3), n | 46 (5.5) |
Moderate (NRS 4–6), n | 329 (39.3) |
Severe (NRS 7–10), n | 462 (55.2) |
Pain duration, months | 12.00 (6.00; 49.00) |
Opioid usage, n | 284 (33.9) |
Sleep disturbance, n | 273 (32.6) |
EQ-5D-5L | |
Mobility, >2, n | 433 (51.8) |
Self-care, >2, n | 144 (17.2) |
Usual activities, >2, n | 248 (29.6) |
Pain/discomfort, >2, n | 587 (70.1) |
Anxiety/depression, >2, n | 214 (25.6) |
EQ-VAS, 0–100 | 61.87 ± 17.89 (10–100) |
EQ-5D-5L index | 0.63 ± 0.18 (−0.08–1.00) |
Frailty status, n | |
Robust | 244 (29.2) |
Pre-frail | 409 (48.9) |
Frail | 184 (22.0) |
Cluster Label | Cluster 1 (n = 122) | Cluster 2 (n = 172) | Cluster 3 (n = 370) | Cluster 4 (n = 173) | p-Value |
---|---|---|---|---|---|
Patient characteristics | |||||
Age, years | 71.90 ± 6.69 (60–88) | 71.86 ± 7.37 (60–91) | 72.13 ± 7.21 (60–96) | 71.97 ± 7.12 (60–91) | 0.975 |
Female sex, n ** | 86 (70.5) 2 | 98 (57.0) 1,3,4 | 258 (69.7) 2 | 120 (69.4) 2 | 0.017 |
BMI, kg/m2 | 22.62 (20.75; 24.44) | 23.14 (21.64; 25.35) | 22.89 (20.77; 25.58) | 22.83 (20.52; 24.85) | 0.141 |
Comorbid medical disease, n | |||||
Hypertension | 37 (30.3) | 57 (33.1) | 106 (28.6) | 51 (29.5) | 0.763 |
Diabetes mellitus | 15 (12.3) | 35 (20.3) | 64 (17.3) | 32 (18.5) | 0.335 |
Cancer | 19 (15.6) | 29 (16.9) | 54 (14.6) | 28 (16.2) | 0.911 |
Mental health problems | 11 (9.0) | 22 (12.8) | 49 (13.2) | 25 (14.5) | 0.561 |
Osteopenia/osteoporosis | 13 (10.7) | 23 (13.4) | 42 (11.4) | 26 (15.0) | 0.580 |
Spine surgery history | 21 (17.2) | 38 (22.1) | 96 (25.9) | 42 (24.3) | 0.245 |
Pain-related data | |||||
Baseline pain score | |||||
Mild (NRS 1–3), n ** | 5 (4.1) 3,4 | 4 (2.3) 3.4 | 26 (7.0) 1,2 | 11 (6.4) 1,2 | <0.001 |
Moderate (NRS 4–6), n | 34 (27.9) 3,4 | 54 (31.4) 3,4 | 162 (43.8) 1,2 | 79 (45.7) 1,2 | |
Severe (NRS 7–10), n | 83 (68.0) 3,4 | 114 (66.3) 3,4 | 182 (49.2) 1,2 | 83 (48.0) 1,2 | |
Pain duration, months | 13.50 (6.00; 60.00) | 12.00 (5.00; 36.00) | 24.00 (6.00; 60.00) | 12.00 (6.00; 38.00) | 0.050 |
Opioid usage, n | 38 (31.1) | 63 (36.6) | 123 (33.2) | 60 (34.7) | 0.777 |
Sleep disturbance, n | 51 (41.8) | 61 (35.5) | 112 (30.3) | 49 (28.3) | 0.053 |
EQ-5D-5L | |||||
EQ-VAS, 0–100 * | 56.80 ± 18.53 (10–90) 2,3,4 | 63.84 ± 16.16 (20–100) 1 | 62.01 ± 18.10 (10–100) 1 | 63.21 ± 18.11 (10–100) 1 | 0.005 |
EQ-5D-5L index * | 0.55 ± 0.18 (0.16–0.83) 3,4 | 0.55 ± 0.17 (0.08–0.80) 3,4 | 0.66 ± 0.17 (−0.08–1.00) 1,2 | 0.69 ± 0.15 (0.19–0.86) 1,2 | <0.001 |
Frailty status, n ** | |||||
Robust | 29 (23.8) 2,3,4 | 19 (11.0) 1,3,4 | 135 (36.5) 1,2,4 | 61 (35.3) 1,2,3 | <0.001 |
Pre-frail | 64 (52.5) 2,3,4 | 104 (60.5) 1,3,4 | 152 (41.1) 1,2,4 | 89 (51.4) 1,2,3 | |
Frail | 29 (23.8) 2,3,4 | 49 (28.5) 1,3,4 | 83 (22.4) 1,2,4 | 23 (13.3) 1,2,3 |
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Kim, H.J.; Kim, H.C.; Hwang, J.; Kim, S.H. Comparing Frailty Status Among Clusters Identified Based on EQ-5D-5L Dimensions in Older Patients with Chronic Low Back Pain. Medicina 2025, 61, 1217. https://doi.org/10.3390/medicina61071217
Kim HJ, Kim HC, Hwang J, Kim SH. Comparing Frailty Status Among Clusters Identified Based on EQ-5D-5L Dimensions in Older Patients with Chronic Low Back Pain. Medicina. 2025; 61(7):1217. https://doi.org/10.3390/medicina61071217
Chicago/Turabian StyleKim, Hee Jung, Hyeon Chang Kim, Jisung Hwang, and Shin Hyung Kim. 2025. "Comparing Frailty Status Among Clusters Identified Based on EQ-5D-5L Dimensions in Older Patients with Chronic Low Back Pain" Medicina 61, no. 7: 1217. https://doi.org/10.3390/medicina61071217
APA StyleKim, H. J., Kim, H. C., Hwang, J., & Kim, S. H. (2025). Comparing Frailty Status Among Clusters Identified Based on EQ-5D-5L Dimensions in Older Patients with Chronic Low Back Pain. Medicina, 61(7), 1217. https://doi.org/10.3390/medicina61071217