Female Gender Was a Protective Factor for Patients with Frailty Undergoing Total Knee or Hip Replacement

Abstract Background Women reported significantly poorer health and poorer outcomes in some surgeries than men. As the patients with frailty got more and more attention in joint placement. It is necessary to find whether frail women also need to be paid more attention after TKA or THA. Further, it is also needed to discuss specifically the different impacts of sex in the perioperative period for frail patients undergoing TKA or THA. Method We used the frailty-defining diagnosis cluster and the discharge data from the National Inpatient Sample database of patients who underwent THA and TKA. Bivariate and multivariate analysis methods were performed to find the association between sex and patient characteristics and postoperative complications of these patients. Result Frail patients undergoing TKA comprised 34.6% male and 65.4% female. In the multivariate analysis, the female sex was found to be a protective factor for mortality, acute cardiac events, acute renal failure, pneumonia, DVT_PE, and postoperative delirium. Frail patients undergoing THA were 39.5% male and 60.4% female. In the multivariate analysis, the female sex was found to be a protective factor for acute cardiac events, acute pulmonary edema, acute renal failure, and pneumonia. Moreover, whether in TKA or THA, the male sex rather than the female sex is closely associated with serious comorbidities. Lower hospital costs were also associated with the female sex. Conclusion Female sex acts as a protective factor for postoperative complications of THA or TKA. Therefore, frail men rather than frail women need more attention from clinicians, although the proportion of frail women is far greater than that of men.