%0 Journal Article
%T Outcomes following hip fracture surgery in adults with schizophrenia in Ontario, Canada: A 10-year population-based retrospective cohort study.
%A Ansari H
%A Fung K
%A Cheung AM
%A Jaglal S
%A Bogoch ER
%A Kurdyak PA
%J Gen Hosp Psychiatry
%V 89
%N 0
%D 2024 Jul-Aug 19
%M 38797059
%F 7.587
%R 10.1016/j.genhosppsych.2024.05.010
%X <B>OBJECTIVE: </B>To understand immediate and long-term outcomes following hip fracture surgery in adults with schizophrenia.<BR><B>METHODS: </B>Retrospective population-based cohort study leveraging health administrative databases from Ontario, Canada. Individuals aged 40-105 years with hip fracture surgery between April 1, 2009 and March 31, 2019 were included. Schizophrenia was ascertained using a validated algorithm. Outcomes were: 30-day mortality; 30-day readmission; 1-year survival; and subsequent hip fracture within 2 years. Analyses incorporated Generalized Estimating Equation models, Kaplan-Meier curves, and Fine-Gray competing risk models.<BR><B>RESULTS: </B>In this cohort study of 98,126 surgically managed hip fracture patients, the median [IQR] age was 83[75-89] years, 69.2% were women, and 3700(3.8%) had schizophrenia. In Fine-Gray models, schizophrenia was associated with subsequent hip fracture (sdRH, 1.29; 95% CI, 1.09-1.53), with male patients with schizophrenia sustaining a refracture 50 days earlier. In age- and sex-adjusted GEE models, schizophrenia was associated with 30-day mortality (OR, 1.31; 95% CI, 1.12-1.54) and readmissions (OR, 1.40; 95% CI, 1.25-1.56). Kaplan-Meier survival curves suggested that patients with schizophrenia were less likely to be alive at 1-year.<BR><B>CONCLUSIONS: </B>Study highlights the susceptibility of hip fracture patients with schizophrenia to worse outcomes, including refracture, with implications for understanding modifiable processes of care to optimize their recovery.