Avanish Yendluri, Mateo Restrepo Mejia, Brocha Z Stern, Charles Laurore, Rodnell Busigo Torres, Steven Yacovelli, Carolina Stocchi, Jashvant Poeran, Jeremy D Podolnick, David A Forsh
{"title":"髋部骨折患者主要口语与围手术期预后的关系","authors":"Avanish Yendluri, Mateo Restrepo Mejia, Brocha Z Stern, Charles Laurore, Rodnell Busigo Torres, Steven Yacovelli, Carolina Stocchi, Jashvant Poeran, Jeremy D Podolnick, David A Forsh","doi":"10.5435/JAAOSGlobal-D-25-00110","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Recently, the role of a patient's primary spoken language (PSL) has emerged as a potential contributor to perioperative outcomes. This study aimed to identify the association between a patient's PSL and hip fracture perioperative outcomes, including hospital length of stay (LOS), in-hospital mortality, nonhome discharge, 30-day emergency department visits, 90-day readmissions, and 90-day complications.</p><p><strong>Methods: </strong>An institutional review board-approved retrospective cohort study was performed using institutional data. Two cohorts were created for patients who underwent either open reduction and internal fixation (ORIF) or arthroplasty (total or hemiarthroplasty) for a hip fracture in 2016 to 2023 in a multihospital academic health system. Within each cohort, patients with non-English and English PSL were matched 1:3 based on age, sex, insurance, American Society of Anesthesiologists Classification, dementia, and obesity. Generalized linear models measured associations between PSL and outcomes, adjusting for Charlson Comorbidity Index; adjusted odds ratios are reported for binary outcomes and adjusted mean differences are reported for continuous outcomes.</p><p><strong>Results: </strong>The matched cohorts included 729 patients undergoing ORIF and 473 undergoing arthroplasty. In multivariable analyses in the ORIF cohort, non-English PSL (versus English) was associated with a markedly longer LOS by an average of 0.95 days (95% confidence interval [CI], 0.28 to 1.62, P = 0.01) and decreased likelihood of discharge to a nonhome setting (odds ratio = 0.62, 95% confidence interval, 0.39 to 0.98, P = 0.04). For arthroplasty, non-English PSL (versus English) was markedly associated with shorter LOS by an average of 1.04 days (95% CI, -1.99 to -0.09, P = 0.03). No notable associations were identified between PSL and the other outcomes.</p><p><strong>Conclusion: </strong>These findings suggest language-based differences in perioperative outcomes for surgical management of hip fracture. Further research is needed to identify the mechanisms of these associations and evaluate the clinical significance on long-term outcomes.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204146/pdf/","citationCount":"0","resultStr":"{\"title\":\"Associations Between Patients' Primary Spoken Language and Perioperative Outcomes After Hip Fracture.\",\"authors\":\"Avanish Yendluri, Mateo Restrepo Mejia, Brocha Z Stern, Charles Laurore, Rodnell Busigo Torres, Steven Yacovelli, Carolina Stocchi, Jashvant Poeran, Jeremy D Podolnick, David A Forsh\",\"doi\":\"10.5435/JAAOSGlobal-D-25-00110\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Recently, the role of a patient's primary spoken language (PSL) has emerged as a potential contributor to perioperative outcomes. This study aimed to identify the association between a patient's PSL and hip fracture perioperative outcomes, including hospital length of stay (LOS), in-hospital mortality, nonhome discharge, 30-day emergency department visits, 90-day readmissions, and 90-day complications.</p><p><strong>Methods: </strong>An institutional review board-approved retrospective cohort study was performed using institutional data. Two cohorts were created for patients who underwent either open reduction and internal fixation (ORIF) or arthroplasty (total or hemiarthroplasty) for a hip fracture in 2016 to 2023 in a multihospital academic health system. Within each cohort, patients with non-English and English PSL were matched 1:3 based on age, sex, insurance, American Society of Anesthesiologists Classification, dementia, and obesity. Generalized linear models measured associations between PSL and outcomes, adjusting for Charlson Comorbidity Index; adjusted odds ratios are reported for binary outcomes and adjusted mean differences are reported for continuous outcomes.</p><p><strong>Results: </strong>The matched cohorts included 729 patients undergoing ORIF and 473 undergoing arthroplasty. In multivariable analyses in the ORIF cohort, non-English PSL (versus English) was associated with a markedly longer LOS by an average of 0.95 days (95% confidence interval [CI], 0.28 to 1.62, P = 0.01) and decreased likelihood of discharge to a nonhome setting (odds ratio = 0.62, 95% confidence interval, 0.39 to 0.98, P = 0.04). For arthroplasty, non-English PSL (versus English) was markedly associated with shorter LOS by an average of 1.04 days (95% CI, -1.99 to -0.09, P = 0.03). No notable associations were identified between PSL and the other outcomes.</p><p><strong>Conclusion: </strong>These findings suggest language-based differences in perioperative outcomes for surgical management of hip fracture. Further research is needed to identify the mechanisms of these associations and evaluate the clinical significance on long-term outcomes.</p>\",\"PeriodicalId\":45062,\"journal\":{\"name\":\"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews\",\"volume\":\"9 7\",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-07-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204146/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5435/JAAOSGlobal-D-25-00110\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5435/JAAOSGlobal-D-25-00110","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Associations Between Patients' Primary Spoken Language and Perioperative Outcomes After Hip Fracture.
Introduction: Recently, the role of a patient's primary spoken language (PSL) has emerged as a potential contributor to perioperative outcomes. This study aimed to identify the association between a patient's PSL and hip fracture perioperative outcomes, including hospital length of stay (LOS), in-hospital mortality, nonhome discharge, 30-day emergency department visits, 90-day readmissions, and 90-day complications.
Methods: An institutional review board-approved retrospective cohort study was performed using institutional data. Two cohorts were created for patients who underwent either open reduction and internal fixation (ORIF) or arthroplasty (total or hemiarthroplasty) for a hip fracture in 2016 to 2023 in a multihospital academic health system. Within each cohort, patients with non-English and English PSL were matched 1:3 based on age, sex, insurance, American Society of Anesthesiologists Classification, dementia, and obesity. Generalized linear models measured associations between PSL and outcomes, adjusting for Charlson Comorbidity Index; adjusted odds ratios are reported for binary outcomes and adjusted mean differences are reported for continuous outcomes.
Results: The matched cohorts included 729 patients undergoing ORIF and 473 undergoing arthroplasty. In multivariable analyses in the ORIF cohort, non-English PSL (versus English) was associated with a markedly longer LOS by an average of 0.95 days (95% confidence interval [CI], 0.28 to 1.62, P = 0.01) and decreased likelihood of discharge to a nonhome setting (odds ratio = 0.62, 95% confidence interval, 0.39 to 0.98, P = 0.04). For arthroplasty, non-English PSL (versus English) was markedly associated with shorter LOS by an average of 1.04 days (95% CI, -1.99 to -0.09, P = 0.03). No notable associations were identified between PSL and the other outcomes.
Conclusion: These findings suggest language-based differences in perioperative outcomes for surgical management of hip fracture. Further research is needed to identify the mechanisms of these associations and evaluate the clinical significance on long-term outcomes.