$Sex effects on short-term complications after hip fracture: a prospective cohort study$
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Sex effects on short-term complications after hip fracture: a prospective cohort study

Wilhelmina Ekström,1 Bodil Samuelsson,2 Sari Ponzer,3 Tommy Cederholm,4,5 Karl-Göran Thorngren,6 Margareta Hedström7 1Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, 2...

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Autores principales:	Ekström W, Samuelsson B, Ponzer S, Cederholm T, Thorngren KG, Hedström M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	hip fracture male gender complications associated factors Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/00c46f91443240a0b04c2fb7898d2e33
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spelling	oai:doaj.org-article:00c46f91443240a0b04c2fb7898d2e332021-12-02T00:15:18ZSex effects on short-term complications after hip fracture: a prospective cohort study1178-1998https://doaj.org/article/00c46f91443240a0b04c2fb7898d2e332015-08-01T00:00:00Zhttps://www.dovepress.com/sex-effects-on-short-term-complications-after-hip-fracture-a-prospecti-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Wilhelmina Ekström,1 Bodil Samuelsson,2 Sari Ponzer,3 Tommy Cederholm,4,5 Karl-Göran Thorngren,6 Margareta Hedström7 1Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, 2Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, 3Department of Clinical Science and Education, Section of Orthopaedics, Karolinska Institutet, Södersjukhuset, Stockholm, 4Department of Public Health and Caring Sciences, 5Department of Geriatrics, Uppsala University, Uppsala University Hospital, Uppsala, 6Department of Clinical Sciences, Lund, Orthopaedics, Lund University, Lund, 7Department of Orthopaedics, Institute of Clinical Science, Intervention and Technology (CLINTEC), Karolinska University Hospital, Huddinge, Stockholm, Sweden Objectives: To evaluate potential sex differences and other factors associated with complications within 4 months after a hip fracture.Methods: A total of 1,915 patients ≥65 years (480 men) with hip fracture were consecutively included in a prospective multicenter cohort study. A review of medical records and patient interviews according to a study protocol based on the Standardized Audit of Hip Fractures in Europe (SAHFE, RIKSHÖFT) was performed. Sex differences in comorbidity according to the American Society of Anesthesiologists score and complications 4 months after a hip fracture were registered. Multivariate logistic regression analysis was performed to identify factors related to complications.Results: Male sex was associated with worse general health according to the American Society of Anesthesiologists classification (P=0.005) and with more comorbidities (P<0.001). Male sex emerged as a risk factor for developing pneumonia (P<0.001), and additionally, 18% of the men suffered from cardiac complications compared with 13% of the females (P=0.018). Female sex was predisposed for urinary tract infections, 30% vs 23% in males (P=0.001). Mortality was higher in the male vs female group, both within 30 days (15% vs 10%, P=0.001) and at 4 months (24% vs 14%, P=0.001). Conditions associated with pneumonia were male sex, pulmonary disease, and cognitive impairment. Cardiac complications were associated with delayed surgery and cardiovascular and pulmonary disease.Conclusion: Before surgery, men with hip fracture already have a poorer health status and higher comorbidity rate than women, thus resulting in a twofold increased risk of pneumonia. Cognitive dysfunction and pulmonary disease contributed to pneumonia in men. Delayed surgery seems to increase the risk for cardiac complications. It is important to consider the sex perspective early on together with cardiopulmonary comorbidity and cognitive dysfunction to be able to counteract serious complications that may lead to death. Keywords: hip fracture, male sex, complications, associated factors Ekström WSamuelsson BPonzer SCederholm TThorngren KGHedström MDove Medical Pressarticlehip fracturemale gendercomplicationsassociated factorsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1259-1266 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	hip fracture male gender complications associated factors Geriatrics RC952-954.6
spellingShingle	hip fracture male gender complications associated factors Geriatrics RC952-954.6 Ekström W Samuelsson B Ponzer S Cederholm T Thorngren KG Hedström M Sex effects on short-term complications after hip fracture: a prospective cohort study
description	Wilhelmina Ekström,1 Bodil Samuelsson,2 Sari Ponzer,3 Tommy Cederholm,4,5 Karl-Göran Thorngren,6 Margareta Hedström7 1Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, 2Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, 3Department of Clinical Science and Education, Section of Orthopaedics, Karolinska Institutet, Södersjukhuset, Stockholm, 4Department of Public Health and Caring Sciences, 5Department of Geriatrics, Uppsala University, Uppsala University Hospital, Uppsala, 6Department of Clinical Sciences, Lund, Orthopaedics, Lund University, Lund, 7Department of Orthopaedics, Institute of Clinical Science, Intervention and Technology (CLINTEC), Karolinska University Hospital, Huddinge, Stockholm, Sweden Objectives: To evaluate potential sex differences and other factors associated with complications within 4 months after a hip fracture.Methods: A total of 1,915 patients ≥65 years (480 men) with hip fracture were consecutively included in a prospective multicenter cohort study. A review of medical records and patient interviews according to a study protocol based on the Standardized Audit of Hip Fractures in Europe (SAHFE, RIKSHÖFT) was performed. Sex differences in comorbidity according to the American Society of Anesthesiologists score and complications 4 months after a hip fracture were registered. Multivariate logistic regression analysis was performed to identify factors related to complications.Results: Male sex was associated with worse general health according to the American Society of Anesthesiologists classification (P=0.005) and with more comorbidities (P<0.001). Male sex emerged as a risk factor for developing pneumonia (P<0.001), and additionally, 18% of the men suffered from cardiac complications compared with 13% of the females (P=0.018). Female sex was predisposed for urinary tract infections, 30% vs 23% in males (P=0.001). Mortality was higher in the male vs female group, both within 30 days (15% vs 10%, P=0.001) and at 4 months (24% vs 14%, P=0.001). Conditions associated with pneumonia were male sex, pulmonary disease, and cognitive impairment. Cardiac complications were associated with delayed surgery and cardiovascular and pulmonary disease.Conclusion: Before surgery, men with hip fracture already have a poorer health status and higher comorbidity rate than women, thus resulting in a twofold increased risk of pneumonia. Cognitive dysfunction and pulmonary disease contributed to pneumonia in men. Delayed surgery seems to increase the risk for cardiac complications. It is important to consider the sex perspective early on together with cardiopulmonary comorbidity and cognitive dysfunction to be able to counteract serious complications that may lead to death. Keywords: hip fracture, male sex, complications, associated factors
format	article
author	Ekström W Samuelsson B Ponzer S Cederholm T Thorngren KG Hedström M
author_facet	Ekström W Samuelsson B Ponzer S Cederholm T Thorngren KG Hedström M
author_sort	Ekström W
title	Sex effects on short-term complications after hip fracture: a prospective cohort study
title_short	Sex effects on short-term complications after hip fracture: a prospective cohort study
title_full	Sex effects on short-term complications after hip fracture: a prospective cohort study
title_fullStr	Sex effects on short-term complications after hip fracture: a prospective cohort study
title_full_unstemmed	Sex effects on short-term complications after hip fracture: a prospective cohort study
title_sort	sex effects on short-term complications after hip fracture: a prospective cohort study
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/00c46f91443240a0b04c2fb7898d2e33
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Sex effects on short-term complications after hip fracture: a prospective cohort study

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