Hip Fracture Patterns, Hospital Course, and Mortality Differ Between Males and Females.

Autor:	Doxey SA; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, USA.; Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, MN, USA., Kibble K; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA., Kleinsmith RM; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, USA.; Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, MN, USA., Huyke-Hernández FA; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, USA.; Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, MN, USA., Switzer JA; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, USA.; Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, MN, USA., Cunningham BP; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, USA.; Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, MN, USA.; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.
Jazyk:	angličtina
Zdroj:	Geriatric orthopaedic surgery & rehabilitation [Geriatr Orthop Surg Rehabil] 2024 Oct 16; Vol. 15, pp. 21514593241294048. Date of Electronic Publication: 2024 Oct 16 (Print Publication: 2024).
DOI:	10.1177/21514593241294048
Abstrakt:	Introduction: The purpose of this study was to describe how hip fractures differentially affect male and female patients regarding fracture pattern, hospital course, and postoperative course. Materials and Methods: This retrospective case series was performed in a metropolitan healthcare system involving 2996 hip fracture patients >59 years old who underwent surgical management (eg, intramedullary nail, hemiarthroplasty, percutaneous pinning, etc.). Male patients were matched to female patients using 1:2 nearest neighbor matching on the basis of age and Charlson Comorbidity Index. Outcomes of interest included AO/OTA fracture classification, 30- and 90-day readmission, and 30-day and 1-year mortality rates. Results: The cohort was predominantly female (64.5%). Female patients were more likely to sustain a type 31A fracture compared to males ( P = .016). The average CCI was higher for males vs females (3.0 ± 2.5 vs 2.6 ± 2.3, P < .001). Males were more likely to be readmitted at 30 ( P < .001) and 90 ( P = .015) days after discharge. The 30-day mortality was higher for males vs females (6.6% vs 4.5%, P = .015). Approximately 19.9% of male patients vs 15.1% of females died within a year of surgery ( P < .001). The average time to surgery was longer for males vs females (23.8 ± 18.8 vs 22.5 ± 21.9 h, P = .048). Males were more likely to die within a year if they underwent surgery >24 h after admission ( P = .029). Discussion: Hip fractures have different implications for male and female patients. With age, the incidence of IT fractures increased in females, while it decreased in males. On average, males with hip fractures are sicker than females, which likely contributes to the longer time to surgery as well as increased readmission and mortality rates seen in males. Conclusions: Male and female hip fracture patients are not similar in baseline health status, fracture pattern, or postoperative morbidity and mortality. Orthogeriatricians and other providers that care for this patient population should be aware of these differences when implementing treatment strategies to optimize the recovery of their patients, and while educating patients and their families about postoperative expectations. Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Cunningham’s spouse is the CEO and founder of CODE Technology. Dr Cunningham is a member of the AAOS Health Care Systems and Patient-reported Outcome Measures Committees as well as the chair of the OTA Practice Management Committee. He is also a member of the editorial board for the Journal of Orthopaedic Business. Dr Switzer is committee member for AAOS and AOA. She is also on the editorial board for GOS&R, and a committee member for IGFS. For the remaining authors none were declared. (© The Author(s) 2024.)
Databáze:	MEDLINE
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