Hip Fracture Patterns, Hospital Course, and Mortality Differ Between Males and Females

Abstract

Introduction The purpose of this study was to describe how hip fractures differentially affect male and female patients regarding fracture pattern, hospital course, and postoperative course. Materials and Methods This retrospective case series was performed in a metropolitan healthcare system involving 2996 hip fracture patients >59 years old who underwent surgical management (eg, intramedullary nail, hemiarthroplasty, percutaneous pinning, etc.). Male patients were matched to female patients using 1:2 nearest neighbor matching on the basis of age and Charlson Comorbidity Index. Outcomes of interest included AO/OTA fracture classification, 30- and 90-day readmission, and 30-day and 1-year mortality rates. Results The cohort was predominantly female (64.5%). Female patients were more likely to sustain a type 31A fracture compared to males ( P = .016). The average CCI was higher for males vs females (3.0 ± 2.5 vs 2.6 ± 2.3, P 24 h after admission ( P = .029). Discussion Hip fractures have different implications for male and female patients. With age, the incidence of IT fractures increased in females, while it decreased in males. On average, males with hip fractures are sicker than females, which likely contributes to the longer time to surgery as well as increased readmission and mortality rates seen in males. Conclusions Male and female hip fracture patients are not similar in baseline health status, fracture pattern, or postoperative morbidity and mortality. Orthogeriatricians and other providers that care for this patient population should be aware of these differences when implementing treatment strategies to optimize the recovery of their patients, and while educating patients and their families about postoperative expectations.