• Sumanth R Chandrupatla and Jasvinder A Singh.
• Department of Medicine at the School of Medicine, University of Alabama at Birmingham (UAB) Birmingham, AL, 35233, USA.
• Injury. 2024 Oct 19; 55 (12): 111970111970.

IntroductionWe evaluated the association of patient sex with in-patient mortality and discharge disposition after primary total hip arthroplasty (THA) for hip fracture in the U.S.MethodsUsing the 2016-2019 U.S. National Inpatient Sample (NIS), we calculated adjusted odds ratios (aOR) and 95% confidence intervals (CI) of the association of sex with post-procedural complications and in-hospital mortality after primary THA for hip fracture, adjusting for demographics, social determinants of health, medical comorbidity, hospital characteristics, and post-procedural complications.ResultsThere were 400,930 primary THA procedure hospitalizations for hip fracture in the 2016-2019 NIS data. In multivariable-adjusted analysis, compared to males, female sex was associated with lower in-hospital mortality following THA for hip fracture (aOR 0.65, 95 % CI 0.58 - 0.74; p < 0.001). Multivariable-adjusted analysis showed that female sex was associated with higher odds of discharge to a non-home destination after a THA for hip fracture (aOR 1.14, 95 % CI 1.07 - 1.22; p < 0.001).ConclusionsFemale sex was associated with lower in-hospital mortality after a THA for hip fracture. Further insights into the protective mechanisms that mediate this lower mortality in women undergoing a THA for hip fracture are needed to achieve better outcomes for men in the future.Copyright © 2024. Published by Elsevier Ltd.

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