Lauren A Beaupre1, Jeffrey L Carson2,3, Helaine Noveck3, Jay Magaziner4. 1. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada. 2. Rutgers Biomedical Health Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. 3. Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. 4. Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
Abstract
OBJECTIVES: 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. DESIGN: Cohort study. SETTING: Data were from a randomized clinical trial that compared two blood transfusion protocols after hip fracture. PARTICIPANTS: Individuals with hip fracture (N = 2,016; 489 (24%) male). MEASUREMENTS: 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. RESULTS: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). CONCLUSION: 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.
RCT Entities:
OBJECTIVES: 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. DESIGN: Cohort study. SETTING: Data were from a randomized clinical trial that compared two blood transfusion protocols after hip fracture. PARTICIPANTS: Individuals with hip fracture (N = 2,016; 489 (24%) male). MEASUREMENTS: 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. RESULTS: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). CONCLUSION: 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.
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