{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:39:45Z","timestamp":1791254385003,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hip fractures are a major cause of morbidity and mortality in the elderly. Cognitive impairment is known to be associated with poor postoperative outcomes, but its specific impact on complications following hip fracture surgery remains under\u2010investigated in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nationwide retrospective cohort study used the Diagnosis Procedure Combination (DPC) database to analyze patients aged \u2265\u200965\u2009years who underwent surgical treatment for hip fractures between April 2016 and March 2022. Cognitive impairment was identified using ICD\u201010 codes. Propensity score matching (1:1) was performed using age, sex, body mass index, anesthesia type, fracture classification, surgical procedure, and Charlson Comorbidity Index. The primary outcomes were postoperative complications and in\u2010hospital mortality; secondary outcomes included length of hospital stay and use of anti\u2010osteoporotic medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 474\u2009293 eligible patients, 104\u2009221 had cognitive impairment (22.0%). After matching, 96\u2009982 patients were included in each group. Multivariate logistic regression showed that cognitive impairment was associated with higher risks of venous thromboembolism (odds ratio [OR]: 1.168, 95% confidence interval [CI]: 1.121\u20131.219), urinary tract infection (OR: 1.619, 95% CI: 1.543\u20131.699), and pneumonia (OR: 1.583, 95% CI: 1.510\u20131.661), all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001. In\u2010hospital mortality was similar between groups (2.0% vs. 1.9%). Patients with cognitive impairment had longer hospital stays (36.2\u2009\u00b1\u200929.9 vs. 34.6\u2009\u00b1\u200928.3\u2009days) and lower rates of anti\u2010osteoporotic medication use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cognitive impairment is an independent risk factor for postoperative complications in elderly hip fracture patients. Tailored perioperative strategies are needed to improve outcomes in this high\u2010risk group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70231","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T16:08:57Z","timestamp":1760803737000},"page":"1930-1939","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Increased Risk of Postoperative Complications in Elderly Hip Fracture Patients With Cognitive Impairment: Evidence From a Japanese Nationwide Database"],"prefix":"10.1111","volume":"25","author":[{"given":"Yu","family":"Mori","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Tohoku University Graduate School of Medicine  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunio","family":"Tarasawa","sequence":"additional","affiliation":[{"name":"Department of Health Administration and Policy Tohoku 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