Recovery of Walking Ability and Return to Community Living within 60 Days of Hip Fracture Does Not Differ Between Male and Female Survivors.
Recovery of Walking Ability and Return to Community Living within 60 Days of Hip Fracture Does Not Differ Between Male and Female Survivors.
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DOI：
10.1111/jgs.13535
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发表时间：
2015-08
影响因子：
6.3
通讯作者：
Magaziner J
中科院分区：
文献类型：
--
作者：
Beaupre LA;Carson JL;Noveck H;Magaziner J
比较男性和女性在髋部骨折手术后30天和60天内不行走、在社区居住亚组中回家的能力、在疗养院居民亚组中不行走以及60天内死亡率的风险调整差异。队列研究。数据来自一项随机临床试验，该试验比较了髋部骨折后的两种输血方案。髋部骨折患者（N = 2，016; 489例（24%）男性）。在随机分组后30天和60天的电话随访中确定行走、居住和死亡率，这些随访发生在手术后3天内。使用单变量和多变量回归调整潜在混杂因素，比较每个结局的性别差异。男性在髋部骨折时比女性更年轻（P <0.001），更可能有合并症（P = 0.003），并且在60天内死亡，即使在风险调整后（比值比（OR）= 1.76，95%置信区间（CI）= 1.15-2.69）。经风险调整后，男性和女性患者在髋部骨折后60天不行走的可能性相同（OR = 1.03，95%CI = 0.78-1.34），回家的可能性也相同（OR = 0.90，95%CI = 0.69-1.17）。男性和女性疗养院居民在60天内不走路的差异无统计学意义（OR = 0.95，95%CI = 0.32-2.86）。虽然男性的死亡率较高，但男性幸存者的步行能力有望恢复到与女性幸存者相似的水平，而且他们也有可能重返社区生活。
To compare risk-adjusted differences between men and women 30 and 60 days after hip fracture surgery in not walking, ability to return home in a community-dwelling subset, not walking in a nursing home resident subset, and mortality within 60 days. Cohort study. Data were from a randomized clinical trial that compared two blood transfusion protocols after hip fracture. Individuals with hip fracture (N = 2,016; 489 (24%) male). Walking, dwelling, and mortality were determined in telephone follow-up 30 and 60 days after randomization, which occurred within 3 days of surgery. Sex differences for each outcome were compared using univariate and multivariate regression adjusting for potential confounders. Men were younger (P < .001) and more likely to have comorbidity (P = .003) than women at the time of hip fracture and to die within 60 days, even after risk adjustment (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.15–2.69). After risk adjustment, male survivors were as likely as female survivors not to walk (OR = 1.03, 95% CI = 0.78–1.34) and no less likely to return home (OR = 0.90, 95% CI = 0.69–1.17) 60 days after hip fracture. No differences were noted between male and female nursing home residents in not walking within 60 days (OR = 0.95, 95% CI = 0.32–2.86). Although men experience higher mortality, male survivors can expect recovery of walking ability similar to that of female survivors and are as likely to return to community living.