居住在社会脆弱性增加的地区的患者在髋部骨折手术后住院时间延长和死亡的风险增加。

IF 2.6 2区 医学 Q1 ORTHOPEDICS
Ian Schuster, Parimal Rana, Jane Brennan, Andrea Johnson, James MacDonald, Paul King, Justin Turcotte
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引用次数: 0

摘要

导论:髋部骨折手术患者面临着显著的术后发病率和死亡率风险,并且存在着种族和社会经济差异。本研究使用CDC的社会脆弱性指数(SVI)检验了社会脆弱性对髋部骨折手术后预后的影响。方法:对2020年7月至2023年6月在同一医院接受髋部骨折手术的464例患者进行回顾性研究。比较了低社会脆弱性和高社会脆弱性患者的人口统计学、合并症、手术时间、住院时间(LOS)和术后结果。SVI根据患者居住的邮政编码计算。使用国家SVI分数的第50百分位将患者分为低易感性组和高易感性组。进行单变量和多变量分析,比较两组患者的特征和结果。主要研究终点为术后1年死亡率。结果:两组在人口统计学、合并症或手术方面没有显著差异。社会脆弱性增加的患者1年内死亡率更高(低脆弱性:12.2比高脆弱性:24.0%,P = 0.005),死亡时间更短(340.7比138.9天,P < 0.001)。社会脆弱性较高的患者LOS较长(β = 1.12, 95% CI: 0.35-1.88, P = 0.004), 1年内死亡的可能性高出2.37倍(OR = 2.37, 95% CI: 1.30-4.27, P = 0.004),任何时间死亡的可能性高出1.75倍(OR = 1.75, 95% CI: 1.01-2.99, P = 0.045)。结论:与生活在社会脆弱程度较低地区的患者相比,生活在社会脆弱程度较高地区的患者更有可能经历更长的LOS,更有可能在1年内或髋部骨折手术后的任何时间死亡。这些发现强调了干预措施的必要性,旨在解决髋部骨折护理途径中的社会因素,以减轻患者预后的社会经济差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patients Residing in Areas of Increased Social Vulnerability Are at an Increased Risk for Prolonged Length of Stay and Mortality After Hip Fracture Surgery.

Introduction: Patients undergoing hip fracture surgery face notable risks of postoperative morbidity and mortality, and racial and socioeconomic disparities in outcomes exist. This study examined the effect of social vulnerability on outcomes after hip fracture surgery using the CDC's Social Vulnerability Index (SVI).

Methods: A retrospective study of 464 patients undergoing hip fracture surgery at a single institution from July 2020 to June 2023 was conducted. Demographics, comorbidities, time to surgery, length of stay (LOS), and postoperative outcomes were compared between patients with low versus high social vulnerability. SVI was calculated based on patient's zip code of residence. The 50th percentile of national SVI scores was used to divide patients into low and high vulnerability groups. Univariate and multivariable analyses were done to compare patient characteristics and outcomes between the groups. The primary outcome of interest was 1-year postoperative mortality.

Results: No notable differences were observed in demographics, comorbidities, or procedure performed between the groups. Patients with increased social vulnerability had a higher rate of mortality within 1 year (low vulnerability: 12.2 vs. high vulnerability: 24.0%, P = 0.005) and a shorter time to mortality (340.7 vs. 138.9 days, P < 0.001). Patients with higher social vulnerability had longer LOS (β = 1.12, 95% CI: 0.35-1.88, P = 0.004), were 2.37 times more likely to experience mortality within 1 year (OR = 2.37, 95% CI: 1.30-4.27, P = 0.004), and 1.75 times more likely to experience mortality at any time (OR = 1.75, 95% CI: 1.01-2.99, P = 0.045).

Conclusion: Patients residing in areas of increased social vulnerability were more likely to experience a longer LOS, and more likely to die within 1 year, or at any time after undergoing hip fracture surgery, when compared with those living less socially vulnerable regions. These findings highlight the need for interventions aimed at addressing social factors within hip fracture care pathways to mitigate socioeconomic disparities in patient outcomes.

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来源期刊
CiteScore
6.10
自引率
6.20%
发文量
529
审稿时长
4-8 weeks
期刊介绍: The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues. Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.
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