Sex Differences in Complications Following Total Hip Arthroplasty: A Population-Based Study.

Autor: Grant S; Divison of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada., Pincus D; Divison of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; ICES, Toronto, Canada., Ruangsomboon P; Divison of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Orthopaedics Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Lex J; Divison of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada., Sheth U; Divison of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; ICES, Toronto, Canada., Ravi B; Divison of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; ICES, Toronto, Canada.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2024 Dec; Vol. 39 (12), pp. 3004-3008. Date of Electronic Publication: 2024 May 24.
DOI: 10.1016/j.arth.2024.05.062
Abstrakt: Background: The relationship between sex and outcomes, especially complications, after total hip arthroplasty (THA) has not been well established. This study aimed to identify if patient biological sex significantly impacted complications after THA in Ontario, Canada.
Methods: A population-based retrospective cohort study of patients undergoing primary THA in Ontario from April 1, 2015 to March 31, 2020 was conducted. The primary outcome was major surgical complications within a year postsurgery (a composite of revision, deep infection requiring surgery, and dislocation). Secondary outcomes included the individual component of the composite primary outcome and major medical complications within 30 days. Proportional hazards regression calculated the adjusted hazards ratio for major surgical complications in men relative to women, adjusting for age, comorbidities, neighborhood income quintile, surgeon and hospital volume, and year of surgery.
Results: A total of 67,077 patients (median age 68 years; 54.1% women) from 61 hospitals were included; women were older with a higher prevalence of frailty. Women had a higher rate of major surgical complications within 1 year of surgery compared to men (2.9 versus 2.5%, adjusted odds ratio 1.19, 95% confidence interval 1.08 to 1.33, P = .0009). Conversely, men had a higher risk for medical complications within 30 days (6.3 versus 2.7%, P < .001).
Conclusions: Observable sex disparities exist in post-THA complications; women face surgical complications predominantly, while medical complications are more prevalent in men. These insights can shape preoperative patient consultations.
Level of Evidence: Level III.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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