Gender differences in patients with hip fracture: A greater risk of morbidity and mortality in men
Gender differences in patients with hip fracture: A greater risk of morbidity and mortality in men
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DOI：
10.1097/00005131-200501000-00006
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发表时间：
2005-01-01
影响因子：
2.3
通讯作者：
Koval, KJ
中科院分区：
文献类型：
--
作者：
Endo, Y;Aharonoff, GB;Koval, KJ
目的：确定老年髋部骨折患者骨折前状态和术后结果的性别差异，这些患者在骨折前是流动的、社区居住的、认知完好的。设计：回顾性分析前瞻性收集的数据。单位：城市骨科转诊医院。患者：共有983名连续的非病理性髋部骨折患者（206名男性，777名女性）被随访了至少12个月。干预措施：股骨近端骨折的手术治疗。主要观察指标：术后医疗并发症、出院地点、1年死亡率、术后行走、基本日常生活活动和日常生活工具活动恢复情况。结果：髋部骨折前，男性更有可能已婚或与他人同居，并且他们在日常生活中的工具活动上比女性更依赖。此外，男性的病情更重，这一点在美国麻醉医师协会的术前风险评分中得到了证明。术后，与女性相比，男性更有可能维持医学并发症，1年死亡率更高。在患者的年龄、骨折类型、骨折前的帮助水平、下床活动、基本日常生活活动的依赖程度、出院地点、下床活动以及基本日常生活活动和器械活动的术后恢复情况等方面，性别差异均无统计学意义。结论：男性是维持术后并发症的危险因素，也是髋部骨折后1年死亡率较高的危险因素。
Objective: To determine gender-specific differences in prefracture status and postoperative outcome in elderly hip fracture patients who were ambulatory, community-dwelling, and cognitively intact prior to fracture.Design: Retrospective analysis of prospectively collected data. Setting: Urban orthopedic referral hospital.Patients: A total of 983 consecutive patients (206 males and 777 females) who sustained a nonpathologic hip fracture were followed for a minimum of 12 months.Intervention: Operative treatment of a proximal femur fracture.Main Outcome Measurements: postoperative medical complications, place of discharge, 1-year mortality, and postoperative recovery of ambulation, basic activities of daily living, and instrumental activities of daily living.Results: Men were more likely to be married or living with someone else, and they were more dependent in instrumental activities of daily living than women prior to hip fracture. Furthermore, men were sicker as evidenced by a higher American Society of Anesthesiologists rating of preoperative risk. Postoperatively, men were more likely to sustain a medical complication and had a higher mortality at 1 year compared to women. There were no statistically significant gender differences in patient age, fracture type, prefracture level of help, ambulation, or dependence in basic activities of daily living, place of discharge, and postoperative recovery of ambulation as well as basic and instrumental activities of daily living.Conclusions: Male gender was a risk factor for sustaining a postoperative complication as well as a higher mortality at 1 year post hip fracture.