Hip fractures after 60 years of age in France in 2005–2017: Nationwide sample of statutory-health-insurance beneficiaries

Boukebous, Baptiste; Gao, Fei; Biau, David

doi:10.1016/j.otsr.2023.103677

Orthopaedics & Traumatology: Surgery & Research

2023

DOI: 10.1016/j.otsr.2023.103677

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Hip fractures after 60 years of age in France in 2005–2017: Nationwide sample of statutory-health-insurance beneficiaries

Baptiste Boukebous,

Fei Gao,

David Biau

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2024

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Cited by 3 publications

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“…Boukebous et al reported that 77% of patients with hip fracture were female, which possibly explains why Wallis et al identified that female emergent cases had significantly higher rates of adverse postoperative events when treated by male surgeons, because of the overrepresentation and high mortality and readmission rate of femoral fracture patients, rather than being linked to the sex of the surgeon.…”

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confidence: 99%

Examining Gender Disparities Among Physicians When Sample Sizes Differ

Rehm,

Hatzantoni,

Sheharyar

2024

JAMA Surg

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To the Editor We read with interest the recent publication by Wallis and colleagues. 1 There are several mismatches between the male-female groups, which support that the reported outcome differences in mortality, readmission, and complication rate might be the result of male surgeons having performed more complex surgeries (high complexity: male surgeons = 65.7%; female surgeons = 59.5%) on older patients (mean patient age: male surgeons = 60 years; female surgeon = 52.5 years) with more serious medical problems (comorbidity aggregate disease group ≥11: male surgeons = 20.3%; female surgeons = 17.7%).Wallis et al 1 included 12.2 times more male than female orthopedic surgeons who performed 29.5 times the number of surgeries, creating an overrepresentation in the male cohort of patients with femoral fracture, who are associated with a high complication rate. Haugan et al 2 reported a 90-day and 1-year mortality rate of 13.8% and 25.9%, respectively, and a 90-day and 1-year readmission rate of 23.7% and 39.8%, respectively, after hip fracture surgery.Boukebous et al 3 reported that 77% of patients with hip fracture were female, which possibly explains why Wallis et al 1 identified that female emergent cases had significantly higher rates of adverse postoperative events when treated by male surgeons, because of the overrepresentation and high mortality and readmission rate of femoral fracture patients, rather than being linked to the sex of the surgeon.Wallis et al 1 included 15.8 times more male than female neurosurgeons, but male neurosurgeons performed 19.6 times the number of surgeries. This imbalance creates further bias against male surgeons, considering the high surgical mortality rate for nonelective surgeries and high readmission rates in this specialty. Donoho et al 4 reported 30-and 90-day readmission rates after craniotomy for malignant brain tumors of 13.2% and 25.7%, respectively, excluding planned readmissions for chemotherapy. Wallis et al 1 did not identify how many of the readmissions were planned and not due to an adverse event.

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mentioning

confidence: 99%

Examining Gender Disparities Among Physicians When Sample Sizes Differ

Rehm,

Hatzantoni,

Sheharyar

2024

JAMA Surg

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Incidence and Survival After Hip Fractures in Chile in Patients Over Age 60: Implications for Public Health Policies

Barahona,

Matus,

Mondschein

2024

SSRN Journal

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Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune–Inflammatory–Metabolic Markers and Related Conceptual Issues

Fisher,

Srikusalanukul

2024

JCM

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Objectives: This study, based on the concept of immuno-inflammatory–metabolic (IIM) dysregulation, investigated and compared the prognostic impact of 27 indices at admission for prediction of postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In consecutive HF patient (n = 1273, mean age 82.9 ± 8.7 years, 73.5% females) demographics, medical history, laboratory parameters, and outcomes were recorded prospectively. Multiple logistic regression and receiver-operating characteristic analyses (the area under the curve, AUC) were used to establish the predictive role for each biomarker. Results: Among 27 IIM biomarkers, 10 indices were significantly associated with development of PMI and 16 were indicative of a fatal outcome; in the subset of patients aged >80 years with ischaemic heart disease (IHD, the highest risk group: 90.2% of all deaths), the corresponding figures were 26 and 20. In the latter group, the five strongest preoperative predictors for PMI were anaemia (AUC 0.7879), monocyte/eosinophil ratio > 13.0 (AUC 0.7814), neutrophil/lymphocyte ratio > 7.5 (AUC 0.7784), eosinophil count < 1.1 × 109/L (AUC 0.7780), and neutrophil/albumin × 10 > 2.4 (AUC 0.7732); additionally, sensitivity was 83.1–75.4% and specificity was 82.1–75.0%. The highest predictors of in-hospital death were platelet/lymphocyte ratio > 280.0 (AUC 0.8390), lymphocyte/monocyte ratio < 1.1 (AUC 0.8375), albumin < 33 g/L (AUC 0.7889), red cell distribution width > 14.5% (AUC 0.7739), and anaemia (AUC 0.7604), sensitivity 88.2% and above, and specificity 85.1–79.3%. Internal validation confirmed the predictive value of the models. Conclusions: Comparison of 27 IIM indices in HF patients identified several simple, widely available, and inexpensive parameters highly predictive for PMI and/or in-hospital death. The applicability of IIM biomarkers to diagnose and predict risks for chronic diseases, including OP/OF, in the preclinical stages is discussed.

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Hip fractures after 60 years of age in France in 2005–2017: Nationwide sample of statutory-health-insurance beneficiaries

Cited by 3 publications

References 36 publications

Examining Gender Disparities Among Physicians When Sample Sizes Differ

Examining Gender Disparities Among Physicians When Sample Sizes Differ

Incidence and Survival After Hip Fractures in Chile in Patients Over Age 60: Implications for Public Health Policies

Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune–Inflammatory–Metabolic Markers and Related Conceptual Issues

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