Evidence map›Paper›PMID 40549005›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Temporal trends in socioeconomic inequalities and risk of infection after hip fracture surgery: a nationwide cohort study, 2010-2021.

Nadia R Gadgaard, Claus Varnum, Rob Nelissen, Christina Vandenbroucke-Grauls, Alma B Pedersen

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In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Nadia R GadgaardDepartment of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Olof Palmes Allé 43, 8200, Aarhus, Denmark. nadia.gadgaard@gmail.com.ORCID http://orcid.org/0000-0003-1199-439X
Claus VarnumDepartment of Orthopedic Surgery, Lillebaelt Hospital, Vejle, Denmark.
Rob NelissenDepartment of Orthopedics, Leiden University Medical Center, Leiden, the Netherlands.
Christina Vandenbroucke-GraulsDepartment of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Olof Palmes Allé 43, 8200, Aarhus, Denmark.
Alma B PedersenDepartment of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Olof Palmes Allé 43, 8200, Aarhus, Denmark.

Funding

Helsefonden 20-B-0140
6 · The paper itself

Abstract

Socioeconomic inequalities in 30-day risk of any infection after hip fracture surgery increased from 2010 to 2021. The results indicate a growing health gap among patients with hip fracture, whereby lower education, lack of social support, and reliance on informal or residential care represent increasing disadvantages. PURPOSE: To investigate whether socioeconomic inequalities in infection risk after hip fracture changed between 2010 and 2021.

methodUsing Danish population-based registries, we identified 74,068 patients with hip fracture. We collected data on socioeconomic position markers (education, liquid assets, marital status, and living arrangements) to examine their effect on risk of post-surgical infection. We studied any hospital-treated infection or community-treated infection occurring within 30 days after surgery during four calendar periods. We computed the cumulative incidences of infections. We measured inequality over time by estimating the adjusted slope index of inequality (SII), a hazard difference of infection/100 person years, using additive hazard regression and adjusted relative index of inequality (RII), a relative hazard, using Cox proportional hazard regression. We calculated 95% confidence intervals for all estimates.

resultsThe incidence of hospital-treated infections (in total 12,654 patients) ranged between 14 and 21% and that of community-treated infections (in total 20,523 patients) ranged between 21 and 38% depending on calendar period and socioeconomic position. During 2010-2021, inequality in hospital-treated infections increased according to education (SII 14 [- 20; 49] and RII 1.1 [0.9; 1.3] in 2010 vs. SII 36 [0; 71] and RII 1.2 [1; 1.3] in 2021) and marital status (SII 29 [- 9; 66] and RII 1.2 [1; 1.4] in 2010 vs. SII 84 [45; 123] and RII 1.4 [1.2; 1.7] in 2021). Similar trends were observed for community-treated infections. Inequality in hospital-treated infection increased according to living arrangements (SII - 32 [- 78; 14] and RII 0.9 [0.7; 1.1] in 2010 vs. SSI 106 [59; 153] and RII 1.5 [1.3; 1.8] in 2021), whereas inequality according to liquid assets remained unchanged over time for both outcomes.

conclusionOur results indicate growing inequality in health among patients with hip fracture, whereby lower education, lack of social support, and reliance on residential care represent increasing disadvantages for infection risk. This gap may have implications for infection prevention and treatment.

Indexed as

Fracture FixationHealthcare DisparitiesHealth Status DisparitiesHip FracturesSurgical Wound InfectionAgedAged, 80 and overCohort StudiesDenmarkEducational StatusFemaleHumansIncidenceMaleMiddle AgedRegistriesEpidemiologyHip fractureInfectionSocioeconomic position

Identifiers

PMID40549005
PMCPMC12612023

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.