title: Gender differences influence the outcome of geriatric rehabilitation following hip fracture.
abstract: Hip fracture represents the most dramatic expression of the disease, in terms of morbidity, medical cost and mortality. The incidence of hip fracture increases substantially with age. The purpose of this study was to evaluate the association between gender and geriatric rehabilitation outcome after traumatic hip fracture. Ninety-nine community-dwelling elderly patients (older than 65 years), 64 women and 35 men, who were admitted to geriatric rehabilitation after operated hip fracture were studied. We assessed the patients' clinical and demographic data, preoperative risk (ASA), type of fracture and orthopedic repair, pain intensity (VAS), cognitive (MMSE), mood (Zung IDS), and functional status (FIM) on admission and at the end of geriatric rehabilitation. Men had higher mean number of comorbid conditions at the time of the fracture. Men recovered more from depressed mood in comparison with women during the rehabilitation. Significant improvement in FIM motor subscore on discharge was found in both groups. The FIM motor subscore gain was higher in men (24.47) in comparison with women (19.22, p=0.036). Those differences were demonstrated in mean subscores of transfers (p=0.004), and locomotion (p=0.019). Women were more functionally dependent in locomotion, transfers and sphincter control. There were no differences between the groups by duration on rehabilitation stay. Recovery after hip fracture depends in large part on the pre-fracture health and functional ability of the patient. Gender differences in functional recovery may affect therapeutic and rehabilitative decision making. Functional recovery after traumatic hip fracture was better in men in comparison with women.
authors.affiliation: Department of Geriatric Medicine, Sapir Medical Center, Kfar Saba 44281, Israel. arinzon@walla.co.il
authors.forename: Zeev
authors.initials: Z
authors.lastname: Arinzon
authors.forename: Shay
authors.initials: S
authors.lastname: Shabat
authors.forename: Alexander
authors.initials: A
authors.lastname: Peisakh
authors.forename: Reuven
authors.initials: R
authors.lastname: Gepstein
authors.forename: Yitshal N
authors.initials: YN
authors.lastname: Berner
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000534:rehabilitation*; D003071:Cognition / Q000502:physiology; D015897:Comorbidity; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods / Q000401:mortality / Q000534:rehabilitation; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000175:diagnosis / Q000401:mortality / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D015601:Injury Severity Score; D007557:Israel; D008297:Male; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome