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The association of female sex with application of evidence-based practice recommendations for perioperative care in hip fracture surgery
- Source :
- CMAJ: Canadian Medical Association Journal. February 11, 2019, Vol. 191 Issue 6, pE151, 8 p.
- Publication Year :
- 2019
-
Abstract
- BACKGROUND: Sex and gender inequality is prevalent in health care, and affects receipt of health care services and outcomes. Our objective was to measure the association between sex and receipt of evidence-based perioperative care for hip fracture in Ontario. METHODS: This was a population-based retrospective cross-sectional analysis. We identified all Ontario residents aged 66 years and older who had hip fracture surgery between 2014 and 2016. After protocol registration, we measured the adjusted association between female sex and perioperative geriatric care (primary outcome), anesthesia consultations, regional analgesia and neuraxial anesthesia (secondary outcomes) using multilevel multivariable adjusted logistic regression. Pre-specified sensitivity analyses were also performed. RESULTS: We identified 22661 patients who had hip fracture surgery; 16162 (71.3%) were women. Women were less likely to receive perioperative geriatric care (adjusted odds ratio [OR] 0.80, 95% confidence interval [Cl] 0.72 to 0.88) and anesthesia consultations (adjusted OR 0.89, 95% CI 0.80 to 0.98); women were more likely to have timely surgery (adjusted OR 1.26, 95% Cl 1.17 to 1.36). Receipt of neuraxial anesthesia (adjusted OR 0.98, 95% Cl 0.93 to 1.04) and regional analgesia (adjusted OR 1.00, 95% Cl 0.94 to 1.07) were not different between sexes. INTERPRETATION: More than 2 out of 3 patients who had hip fracture surgery were women; however, women were less likely to receive perioperative geriatric care and anesthesia consultations. Given the effectiveness of these interventions for improving outcomes, population-level hip fracture outcomes may be improved by decreasing sexbased disparities in application of evidence-based recommended perioperative care. Protocol registration: ClinicalTrials.gov, no. NCT03422497<br />Sex and gender inequality is prevalent in health care, differentially affecting men and women's access to health services and outcomes. (1) lnequalities can arise from unequal accommodation of specific biological [...]
- Subjects :
- Elderly women -- Health aspects
Health care disparities -- Analysis
Health care industry -- Social aspects
Hip fracture repair -- Usage
Hip fractures -- Care and treatment -- Social aspects
Treatment outcome -- Analysis
Equality
Fractures (Injuries)
Women's associations
Hospital patients
Surgery
Gender equality
Evidence-based medicine
Analgesia
Anesthesia
Health care industry
Health
Subjects
Details
- Language :
- English
- ISSN :
- 08203946
- Volume :
- 191
- Issue :
- 6
- Database :
- Gale General OneFile
- Journal :
- CMAJ: Canadian Medical Association Journal
- Publication Type :
- Periodical
- Accession number :
- edsgcl.574056064
- Full Text :
- https://doi.org/10.1503/cmaj.180564