Men Recover Ability to Function Less Than Women Do An Observational Study of 1094 Subjects After Hip Fracture

Di Monaco M, Castiglioni C, Vallero F, Di Monaco R, Tappero R: Men recover ability to function less than women do: an observational study of 1094 subjects after hip fracture. Am J Phys Med Rehabil 2012; 91: 309-315. Objective: The aim of this study was to investigate the association between sex and functional outcome after acute inpatient rehabilitation in hip-fracture patients. Design: We investigated 1094 of 1186 people admitted consecutively to our rehabilitation hospital because of a hip fracture. Functional outcome was assessed using Barthel Index scores. Barthel Index efficiency (improvement per day of stay length) and Barthel Index effectiveness (proportion of potential improvement achieved) were calculated. Results: The median Barthel Index score at discharge from inpatient rehabilitation was 85 in the 970 women and 75 in the 124 men (interquartile range, 65-95 in women and 60-95 in men, P = 0.001). Both Barthel Index efficiency and effectiveness were significantly lower in men (P = 0.030 and P = 0.007, respectively). After adjustment for six confounders, we confirmed that men had lower Barthel Index scores (P = 0.030), Barthel Index efficiency (P = 0.024), and Barthel Index effectiveness (P = 0.040). The risk of achieving a low Barthel Index score (i. e., <85) at the end of acute inpatient rehabilitation was higher for men than for women (adjusted odds ratio, 2.055; 95% CI, 1.212-3.483; P = 0.007). Conclusions: In our large sample of hip-fracture patients, men had a significantly worse functional outcome than did women after acute inpatient rehabilitation.