title: Sex Differences in Hip Fracture Surgery: Preoperative Risk Factors for Delirium and Postoperative Outcomes.
abstract: To describe the differences observed in risk factors for delirium and outcomes between men and women undergoing hip fracture repair surgery.
  
  
  
  Prospective cohort study.
  
  
  
  Academic medical center.
  
  
  
  Individuals with acute hip fracture admitted to an academic medical center (N = 431).
  
  
  
  Information on preoperative demographic characteristics, medical history, laboratory results, and postoperative outcomes was obtained according to history and chart review. Delirium was assessed using the Confusion Assessment Method.
  
  
  
  The overall incidence of postoperative delirium was 34%, with men more likely to experience postoperative delirium (44.8%) than women (30.2%) (P = .004). Male sex was associated with postoperative delirium in individuals with hip fracture, even after adjusting for other preoperative risk factors. Other significant preoperative risk factors included age, dementia, Parkinson's disease, and American Society of Anesthesiologists classification. Men were also more likely to experience other postoperative complications and have longer hospital length of stay.
  
  
  
  Men are at higher risk of postoperative delirium after hip fracture repair than women and have more postoperative surgical complications. Their higher risk of postoperative delirium may be due to their underlying preoperative disease severity.
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland.|Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland.|Department of Pathology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Esther S
authors.initials: ES
authors.lastname: Oh
authors.affiliation: Department of Anesthesiology and Critical Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Frederick E
authors.initials: FE
authors.lastname: Sieber
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jeannie-Marie
authors.initials: JM
authors.lastname: Leoutsakos
authors.affiliation: Aging Brain Center, Institute of Aging Research, Hebrew SeniorLife, Boston, Massachusetts.|Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
authors.affiliation: Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Hochang B
authors.initials: HB
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D000544:Alzheimer Disease / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D003693:Delirium / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000150:complications / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
keywords: delirium; hip fracture; postoperative; risk factors; sex