The association of female sex with application of evidence-based practice recommendations for perioperative care in hip fracture surgery

Cho, Natalie; Boland, Laura; McIsaac, Daniel I.

doi:10.1503/cmaj.180564

Cited by 8 publications

(8 citation statements)

References 45 publications

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“…However, our observed 30-day mortality is higher than expected when considering published rates from emergency general surgeries (6%), 4 or after hip fracture (7%). 5 The high mortality during the 2 weeks before and after COVID-19 diagnosis is likely a combination COVID-19, the emergency nature of the surgery, and the increased comorbidities in patients requiring surgery. The nature of our data did not permit more detailed information about the exact surgery and indication, or about patients' clinical status.…”

Section: Discussion En Chirurgie E248mentioning

confidence: 99%

The requirement for surgery and subsequent 30-day mortality in patients with COVID-19

Welk

Richard

Rodriguez-Elizalde

2021

cjs

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The ongoing COVID-19 pandemic has had profound effects on the provision of surgical care. The potential perioperative mortality associated with surgical procedures in patients with COVID-19 has been estimated at 20%, but the data come from jurisdictions that experienced very high surges of COVID-19 patients. A rapid assessment of the types of surgical care for patients with COVID-19 in Ontario was carried out using administrative data, and we found that during the initial wave in the spring of 2020, surgical interventions were required in 0.6% of patients with COVID-19, and mortality was higher (20%) in patients who underwent surgery in the 2 weeks before or after a positive nasopharygeal swab than in those who had surgery more than 2 weeks after COVID-19 was diagnosed.

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Section: Discussion En Chirurgie E248mentioning

confidence: 99%

The requirement for surgery and subsequent 30-day mortality in patients with COVID-19

Welk

Richard

Rodriguez-Elizalde

2021

cjs

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“…Racial and ethnic disparities in the use of regional anesthesia among trauma patients is understudied. A team of Canadian investigators evaluated disparities among hip fracture patients, specifically focusing on whether gender was associated with surgical delay of 48 hours or less, preoperative anesthesiology consult, receipt of regional anesthesia, and receipt of neuraxial anesthesia 58. Among the 22,661 patients analyzed over a 2-year period, 71.3% were women; women were less likely to receive geriatric medicine as well as preoperative anesthesiology consultations.…”

Section: Regional Analgesic Techniques Appropriate In Traumamentioning

confidence: 99%

“…A team of Canadian investigators evaluated disparities among hip fracture patients, specifically focusing on whether gender was associated with surgical delay of 48 hours or less, preoperative anesthesiology consult, receipt of regional anesthesia, and receipt of neuraxial anesthesia. 58 Among the 22,661 patients analyzed over a 2-year period, 71.3% were women; women were less likely to receive geriatric medicine as well as preoperative anesthesiology consultations. However, they did not find a difference in the receipt of regional anesthesia or neuraxial anesthesia, but this study could not evaluate the impact of race and ethnicity as these data were not available.…”

Section: Regional Analgesic Techniques Appropriate In Traumamentioning

confidence: 99%

Health disparities in regional anesthesia and analgesia for the management of acute pain in trauma patients

Patton

Burton

Milam

et al. 2022

International Anesthesiology Clinics

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“…Research in Canada between 2003 and 2012 revealed that women were less likely than men to receive ideal care for a range of conditions [ 7 , 8 ]. More recent Canadian research also identified gendered disparities in care delivery and patient outcomes for various health conditions including cardiovascular disease [ 9 – 12 ], HIV management [ 13 , 14 ], hip fracture [ 15 ], chronic obstructive pulmonary disease [ 16 ], mental illness [ 17 , 18 ], and emergency surgery [ 19 ]. Another 1225 Canadian women said that truncated discussion of health issues was a frequent problem [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Medical student exposure to women’s health concepts and practices: a content analysis of curriculum at Canadian medical schools

Anderson

Gagliardi

2021

BMC Med Educ

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Background Women’s health (WH) includes a broad array of concerns and challenges that affect health across the lifespan. Considerable research shows that women continue to experience disparities in access to and quality of care. Apart from surveys of medical trainees and faculty, little research and none in Canada examined medical curriculum for WH. This study assessed how Canadian medical schools integrate WH in their curriculum. Methods We used deductive and summative content analysis to describe instances and the nature of WH topics in program and course descriptions that were publicly-available on web sites of Canadian medical schools. We reported results using summary statistics and text examples. We employed a framework, tested in our prior research, that included mention of women’s health principles and practices relevant to any health concern or condition including factors (e.g. sex, gender, social determinants) that influence health, and access to or quality of care. Results We retrieved 1459 documents from 16 medical schools (median 49.5, range 16 to 301). Few mentioned WH (125, 8.6 %), and the quantity of mentions varied by school (range 0.0–37.5 %). Pre-clerkship course documents more frequently mentioned WH (61/374, 17.3 %, chi square 43.2, p < 0.00001) compared with clerkship course documents (58/1067, 5.4 %). Core course documents more frequently mentioned WH (72/542, 13.3 %, chi square 29.0, p < 0.00001) compared with elective course documents WH (47/899, 5.2 %). Overall, documents more frequently referred to the WH domain of social determinants of health (88, 70.4 %). Few documents addressed women’s health (21, 16.8 %), sex or gender (19, 15.2 %), other considerations (15.2 %) or principles/components of women’s health (2, 1.6 %). Most documents that mentioned WH provided little detail about what those concepts referred to or how to optimize WH. Conclusions Based on program and course descriptions, WH may not be well-integrated at Canadian medical schools, and future physicians may not be consistently exposed to the full breadth of WH. This reveals opportunities for enhancing WH in the medical curriculum. Future research is needed to engage stakeholders including women in developing, implementing and evaluating competencies and corresponding curriculum that reflect the full range of WH concepts and practices.

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The association of female sex with application of evidence-based practice recommendations for perioperative care in hip fracture surgery

Cited by 8 publications

References 45 publications

The requirement for surgery and subsequent 30-day mortality in patients with COVID-19

The requirement for surgery and subsequent 30-day mortality in patients with COVID-19

Health disparities in regional anesthesia and analgesia for the management of acute pain in trauma patients

Medical student exposure to women’s health concepts and practices: a content analysis of curriculum at Canadian medical schools

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