{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:49:19Z","timestamp":1785545359307,"version":"3.56.0"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"crossref","award":["Ricerca Corrente 2023"],"award-info":[{"award-number":["Ricerca Corrente 2023"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018703","name":"HORIZON EUROPE European Innovation Council","doi-asserted-by":"crossref","award":["101137227"],"award-info":[{"award-number":["101137227"]}],"id":[{"id":"10.13039\/100018703","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Sex-related differences in outcomes after major orthopaedic surgery remain under-investigated, and the prognostic relevance of a history of venous thromboembolism (VTE) is unclear. The ORTHO-START registry is a prospective, multicenter study including 1,077 consecutive adults undergoing major orthopaedic surgery (elective hip\/knee arthroplasty or urgent hip fracture repair) across six Italian centers between July 2018 and March 2022. Baseline characteristics, perioperative complications, and antithrombotic therapy were collected. The primary outcome was all-cause mortality at 24 months; secondary outcomes were thromboembolic and bleeding events. Multivariable logistic regression identified predictors of mortality. Women represented 72.3% (n\u2009=\u2009775) of the cohort and were older than men (80.6\u2009\u00b1\u200910.0 vs. 76.2\u2009\u00b1\u200913.0 years, p\u2009&lt;\u20090.001). Urgent procedures comprised 65.6% (n\u2009=\u2009706) of surgeries, predominantly involving women (n\u2009=\u2009542). At 24 months, mortality was higher in men (31 vs. 18%, p\u2009=\u20090.018). Independent predictors of mortality included male sex (odds ratio [OR]\u2009=\u20092.6, 95% confidence interval [CI]: 1.8\u20134.0), older age, lower body mass index, urgent surgery (OR\u2009=\u20097.2, 95% CI: 4.1\u201312.4), and prior VTE (OR\u2009=\u20095.7, 95% CI: 1.4\u201323.9). Causes of death were known for 160\/210 (76.2%): neurological complications were most frequent (25%), followed by cardiovascular disease (21.3%) and immobility-related causes (14.4%); pulmonary embolism accounted for 1.3% of deaths. Thrombotic and hemorrhagic events occurred in both sexes without significant differences. Male sex and a history of VTE are independent predictors of long-term mortality following major orthopaedic surgery. Incorporating these factors into preoperative risk assessment may improve management and postoperative outcomes.<\/jats:p>","DOI":"10.1055\/a-2918-4154","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:49:37Z","timestamp":1785538177000},"source":"Crossref","is-referenced-by-count":0,"title":["Sex-Related Differences and Predictors of Mortality in Patients Undergoing Major Orthopaedic Surgery: Insights from the ORTHO-START Registry"],"prefix":"10.1055","clinical-trial-number":[{"clinical-trial-number":"nct02219984","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8980-9783","authenticated-orcid":false,"given":"Elvira","family":"Grandone","sequence":"additional","affiliation":[{"name":"University of Foggia, Apulia, Italy","place":["Foggia"],"department":["Obstetrics and Gynecology"]},{"name":"Fondazione Casa Sollievo della Sofferenza IRCCS, Apulia, Italy","place":["San Giovanni Rotondo"],"department":["Thrombosis and Haemostasis Unit"]},{"name":"Department of  Obstetrics, Gynecology and Perinatal Medicine, Moscow, Russia","place":["Sechenov University"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Antonucci","sequence":"additional","affiliation":[{"name":"Fondazione Arianna Anticoagulazione, Emilia-Romagna, Italy","place":["Bologna"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Piazza","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School, Massachusetts, United States","place":["Boston"],"department":["Division of Cardiovascular Medicine and Thrombosis Research Group"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Barcellona","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, University of Cagliari, Sardegna, Italy","place":["Cagliari"],"department":["Department of Medical Sciences and Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Rostagno","sequence":"additional","affiliation":[{"name":"Careggi University Hospital, Tuscany, Italy","place":["Florence"],"department":["Department of Internal and Postoperative Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Colaizzo","sequence":"additional","affiliation":[{"name":"Fondazione Casa Sollievo della Sofferenza IRCCS, Apulia, Italy","place":["San Giovanni Rotondo"],"department":["Thrombosis and Haemostasis Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"de Laurenzo","sequence":"additional","affiliation":[{"name":"Fondazione Casa Sollievo della Sofferenza IRCCS, Apulia, Italy","place":["San Giovanni Rotondo"],"department":["Thrombosis and Haemostasis Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"di Rienzo","sequence":"additional","affiliation":[{"name":"Department of Pathology , Altamura Hospital, Apulia, Italy","place":["Altamura"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Gorgoglione","sequence":"additional","affiliation":[{"name":"Fondazione Casa Sollievo della Sofferenza IRCCS, Apulia, Italy","place":["San Giovanni Rotondo"],"department":["Orthopedics Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Maccagnano","sequence":"additional","affiliation":[{"name":"Foggia University Hospital, Apulia, Italy","place":["Foggia"],"department":["Department of Orthopedics, Faculty of Medicine and Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Marongiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, University of Cagliari, Sardegna, Italy","place":["Cagliari"],"department":["Department of Medical Sciences and Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mastroianno","sequence":"additional","affiliation":[{"name":"Fondazione Casa Sollievo della Sofferenza IRCCS, Apulia, Italy","place":["San Giovanni Rotondo"],"department":["Scientific Direction"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marzolo","sequence":"additional","affiliation":[{"name":"Ospedale di Rovigo, Veneto, Italy","place":["Rovigo"],"department":["Angiology Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Mirabella","sequence":"additional","affiliation":[{"name":"University of Foggia, Policlinico Riuniti di Foggia, Apulia, Italy","place":["Foggia"],"department":["Department of Medicine, Anesthesia and Intensive Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biagio","family":"Moretti","sequence":"additional","affiliation":[{"name":"School of Medicine, AOU Consorziale Policlinico, University of Bari \"Aldo Moro\", Italy","place":["Bari"],"department":["Orthopedic and Trauma Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Moretti","sequence":"additional","affiliation":[{"name":"Ministero della Salute, Lazio, Italy","place":["Rome"],"department":["Italian Group for Health and Gender (GISeG)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Ostuni","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Policlinico di Bari, Apulia, Italy","place":["Bari"],"department":["Immunohematology and Transfusion Medicine Service"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gualtiero","family":"Palareti","sequence":"additional","affiliation":[{"name":"Fondazione Arianna Anticoagulazione, Emilia-Romagna, 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