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Examining Differences in Recovery Outcomes between Male and Female Hip Fracture Patients: Design and Baseline Results of A Prospective Cohort Study from the Baltimore Hip Studies

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Abstract

Background

Incidence of hip fractures in men is expected to increase, yet little is known about consequences of hip fracture in men compared to women. It is important to investigate differences at time of fracture using the newest technologies and methodology regarding metabolic, physiologic, neuromuscular, functional, and clinical outcomes, with attention to design issues for recruiting frail older adults across numerous settings.

Objectives

To determine whether at least moderately-sized sex differences exist across several key outcomes after a hip fracture.

Design, Setting, & Participants

This prospective cohort study (Baltimore Hip Studies 7th cohort [BHS-7]) was designed to include equal numbers of male and female hip fracture patients to assess sex differences across various outcomes post-hip fracture. Participants were recruited from eight hospitals in the Baltimore metropolitan area within 15 days of admission and were assessed at baseline, 2, 6 and 12 months post-admission.

Measurements

Assessments included questionnaire, functional performance evaluation, cognitive testing, measures of body composition, and phlebotomy.

Results

Of 1709 hip fracture patients screened from May 2006 through June 2011, 917 (54%) were eligible and 39% (n=362) provided informed consent. The final analytic sample was 339 (168 men and 171 women). At time of fracture, men were sicker (mean Charlson score= 2.4 vs. 1.6; p<0.001) and had worse cognition (3MS score= 82.3 vs. 86.2; p<0.05), and prior to fracture were less likely to be on bisphosphonates (8% vs. 39%; p<0.001) and less physically active (2426 kilocalories/week vs. 3625; p<0.001).

Conclusions

This paper provides the study design and methodology for recruiting and assessing hip fracture patients and evidence of baseline and pre-injury sex differences which may affect eventual recovery one year later.

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Authors and Affiliations

  1. Department of Epidemiology and Public Health, School of Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA

    Denise Orwig, M.C. Hochberg, A.L. Gruber-Baldini, J.R. Hebel, R. Johnson & J. Magaziner

  2. School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA

    B. Resnick

  3. Novartis Institutes for BioMedical Research, Cambridge, MA, USA

    R.R. Miller

  4. Department of Physical Therapy, University of Delaware, Newark, DE, USA

    G.E. Hicks

  5. University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

    A.R. Cappola

  6. Longitudinal Studies Section, National Institute on Aging, Baltimore, MD, USA

    M. Shardell

  7. Department of Orthopedics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    R. Sterling

  8. University of Maryland School of Medicine, 660 West Redwood Street, Suite 200, Baltimore, MD, 21201, USA

    Denise Orwig

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  1. Denise Orwig
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  2. M.C. Hochberg
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  3. A.L. Gruber-Baldini
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  4. B. Resnick
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  5. R.R. Miller
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  6. G.E. Hicks
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  7. A.R. Cappola
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  8. M. Shardell
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  9. R. Sterling
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  10. J.R. Hebel
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  11. R. Johnson
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  12. J. Magaziner
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Corresponding author

Correspondence to Denise Orwig.

Electronic supplementary material

Appendix 1

. Study Measures Collected by Time Point; BHS-7 2006–2011

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Orwig, D., Hochberg, M., Gruber-Baldini, A. et al. Examining Differences in Recovery Outcomes between Male and Female Hip Fracture Patients: Design and Baseline Results of A Prospective Cohort Study from the Baltimore Hip Studies. J Frailty Aging 7, 162–169 (2018). https://doi.org/10.14283/jfa.2018.15

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