Gender differences among patients with proximal femur fractures during rehabilitation

Background: Proximal femoral fractures (PFFs) frequently occur in the elderly population and increase with age. Previous studies reported gender differences in previous functional level and co-morbidity among PFF patients. However, data relating to the relationship between gender differences of PFF patients and their rehabilitation outcome is ambiguous. Objective: The aims of the present study were to describe PFF patients within a rehabilitation setting and to examine if there were gender differences between patients. Methods: This was a cohort study of 823 PFF patients (649 women and 174 men; average age, 82.36 [7.62] years) admitted consecutively to the Department of Geriatric Orthopaedic Rehabilitation in a post-acute geriatric rehabilitation center between January 1, 2006 and December 31, 2009. The collected data included demographic variables: variables related to fracture, including fracture type and side, treatment type, time from fracture to operation, and weight bearing instruction; clinical variables, including co-morbidities and albumin and hemoglobin levels; and functional variables, such as patients' pre-fracture functional status and functional level on admission using the Functional Independence Measure, the Mini Mental State Examination, and mood state measured by the Geriatric Depression Screening Scale. Results: More subcapital fractures were found among the men, and more pertrochanteric fractures were found among the women. More men were educated, lived at home with a caregiver, were functionally independent before the fracture event, and had more co-morbidities than women. No significant differences in the functional outcome measures score were found between the 2 genders. Significantly more men died during rehabilitation. Conclusions: The lack of differences in functional gain between the genders during rehabilitation might be explained by the similarity in admission functional and cognitive levels between the genders, which were found to be the most important factors affecting rehabilitation outcome.