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DOS Kongressen 2016 ·
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Is the higher mortality among men with hip
fracture explained by sex-related differences in
quality of in-hospital care? A population-based
cohort study
Pia Kjær Kristensen, Anil Mor, Theis Muncholm Thillemann, Søren Paaske Johnsen,
Alma Becic Pedersen
Department of Orthopedic surgery , Horsens Regional Hospital ; Department of
Clinical Epidemiology, Aarhus University Hospital ; Department of Orthopedic
Surgery, Aarhus University Hospital ; Department of Clinical Epidemiology,
Aarhus University Hospital; Department of Clinical Epidemiology, Aarhus
University Hospital
Background:
Mortality after hip fracture is two-fold higher in men compared
with women. It is unknown whether sex-related differences in the quality of in-
hospital care contribute to the higher mortality among men.
Purpose / Aim of Study:
To examine sex-related differences in quality of in-
hospital care, 30-day mortality, length of hospital stay and readmission among
patients with hip fracture in a population-based cohort study.
Materials and Methods:
Using prospectively collected data from the Danish
Multidisciplinary Hip Fracture Registry, we identified 25,354 patients ¡Ý65
years (29 % were men). Outcome measures included quality of in-hospital care
as reflected by seven process performance measures, 30- day mortality, length
of stay and readmission within 30 days after discharge. Data were analysed us-
ing multivariable regression techniques.
Findings / Results:
In general, there were no substantial sex-related differ-
ences in quality of in- hospital care. The relative risk for receiving the individual
process performance measure ranged from 0.91 (95 % CI 0.85-0.97) to 0.97
(95 % CI 0.94-0.99) for men compared to women. The 30-day mortality was
15.9 % for men and 9.3 % for women corresponding to an adjusted odds ratio
of 2.30 (95 % CI 2.09-2.54). The overall readmission risk within 30 days after
discharge was 21.6 % for men and 16.4 % for women (adjusted odds ratio of
1.38 (95 % CI 1.29-1.47)). No difference in length of stay was observed be-
tween men and women.
Conclusions:
Sex-differences in the quality of in- hospital care appeared not
to explain the higher mortality and risk of readmission among men hospitalized
with hip fracture.
No conflicts of interest reported
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