2026-09-02 リンショーピング大学
＜関連情報＞
- https://liu.se/en/news-item/utbildningsniva-starkast-kopplad-till-overlevnad-efter-hoftfraktur
- https://www.bjanaesthesia.org/article/S0007-0912(26)00503-9/fulltext
スウェーデンにおける急性股関節骨折手術後の社会経済的地位と死亡率：レジストリに基づく全国疫学研究 Socioeconomic status and mortality after acute hip fracture surgery in Sweden: a registry-based nationwide epidemiologic study
Rasmus Åhman ∙ Måns Thulin ∙ Tom E.F. Abbott ∙ … ∙ Anna Oscarsson Tibblin ∙ Karin Björnström Karlsson ∙ Michelle S. Chew
British Journal of Anaesthesia Published:August 5, 2026
DOI:https://doi.org/10.1016/j.bja.2026.06.026
Abstract
Background
The relationship between socioeconomic status and outcomes after hip fracture surgery remains unclear. We aimed to assess the association between individual-level socioeconomic status indicators and mortality after acute hip fracture surgery in Sweden.
Methods
Cross-linked registry-based cohort study of patients undergoing acute hip fracture surgery in Sweden 2015–20. Co-primary outcomes were 30-day and 2-yr all-cause mortality. Socioeconomic status was defined using four indicators: level of education, income, residential area, and receipt of social services. Attributable fractions were calculated to illustrate the potential population-level distribution of mortality differences across SES categories.
Results
There were 58 641 patients included (median age 83 [interquartile range 75–89] yr, 66.1% women). Crude 30-day and 2-yr mortalities were 7.9% (95% confidence interval [CI] 7.7–8.1) and 35.3% (95% CI 34.9–35.7). Level of education showed the strongest association, with a stepwise gradient most pronounced for 2-yr mortality: adjusted odds ratio 1.16 (95% CI 1.08–1.24) for 10–12 yr, 1.20 (95% CI 1.09–1.32) for 9 yr, and 1.25 (95% CI 1.16–1.34) for <9 yr vs >12 yr (all P<0.001). The attributal fraction for 2-yr mortality was 14.0% (standard error 0.022), with an increase in absolute risk of 6.3% (95% CI 4.3–8.2) for >12 yr vs <9 yr of education. Other socioeconomic status factors, except residential area, were also associated with mortality, although less substantially.
Conclusions
Individual socioeconomic status was associated with short- and long-term death after acute hip fracture surgery in Sweden, with education showing the strongest relationship. These findings support consideration of individual-level socioeconomic factors in perioperative hip fracture care at the population level.
