The Association of Sex With Guideline-based Perioperative Care in Hip Fracture Surgery

Completed

• Conditions: Surgery; Anesthesia; Hip Fractures; Gender Bias
• Interventions: Other: Female sex; Other: Male sex

• Registration Number: NCT03422497
• Lead Sponsor: Ottawa Hospital Research Institute

Brief Summary

The investigators will use multilevel multivariable regression analysis to measure the association of sex with provision of guideline-based perioperative care for hip fracture surgery in Ontario.

Detailed Description

In 2013, the Ontario Ministry of Health and Longterm Care published a 'Quality Based Procedures' guideline for care of hip fracture patients. The adjusted association of sex with receipt of 5 perioperative processes of care that can be accurately measured in health administrative data within this guideline will be investigated.

Study Timeline

• Study Start: 2013-05
• Primary Completion: 2016-03
• Study Completion: 2016-03
• Status Verified: 2018-01
• Study First Submitted: 2018-01-17
• Study First Submitted QC: 2018-01-30
• Last Update Submitted: 2018-01-30
• Study First Posted: 2018-02-05
• Last Update Posted: 2018-02-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50000

Inclusion Criteria

• Non-elective hospital admission
• Hip fracture diagnosis
• Hip fracture surgery

Exclusion criteria

-None

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Female hip fracture surgery patients	Female sex	Individuals 65 years or older admitted non-electively to hospital with a diagnosis of hip fracture who have surgery for their hip fracture and have female sex listed in their discharge abstract
Male hip fracture surgery patients	Male sex	Individuals 65 years or older admitted non-electively to hospital with a diagnosis of hip fracture who have surgery for their hip fracture and have male sex listed in their discharge abstract

Primary Outcome Measures

Name	Time	Method
Perioperative geriatric medicine consult	Hospital admission to date of discharge from hospital, or 365 days after admission, whichever came first	Physician billing code for perioperative, inpatient geriatric medicine consult or comprehensive assessment

Secondary Outcome Measures

Name	Time	Method
Preoperative anesthesiology consult	Hospital admission to date of surgery, or 365 days after admission, whichever came first	Physician billing code for preoperative, inpatient anesthesiology consult
Neuraxial anesthesia	Day of surgery	Spinal or epidural anesthesia, without concurrent general anesthesia, administered for the hip fracture surgery and identified from the discharge abstract database section which describes anesthesia techniques for surgery.
Perioperative regional analgesia	Hospital admission to 3 days after surgery	Peripheral nerve block or epidural administered in the perioperative period, identified from physician billing data codes
Wait for surgery greater than 2 days	Hospital admission to date of surgery, or 365 days after admission, whichever came first	Hospital admission to surgery wait for greater than 2 days