General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP Database
Whether the use of neuraxial anesthesia or general anesthesia leads to more favorable postoperative outcomes in patients receiving hip fracture surgery remains unclear. We used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Data Files between 201...
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/11/3827 |
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| author | Ming-Tse Wang Chuen-Chau Chang Chih-Chung Liu Yu-Hsuan Fan Chiang Yu-Ru Vernon Shih Yuan-Wen Lee |
| author_facet | Ming-Tse Wang Chuen-Chau Chang Chih-Chung Liu Yu-Hsuan Fan Chiang Yu-Ru Vernon Shih Yuan-Wen Lee |
| author_sort | Ming-Tse Wang |
| collection | DOAJ |
| description | Whether the use of neuraxial anesthesia or general anesthesia leads to more favorable postoperative outcomes in patients receiving hip fracture surgery remains unclear. We used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Data Files between 2016 and 2020 to investigate the association of neuraxial anesthesia and general anesthesia with morbidity and mortality after hip fracture surgery. Inverse probability of treatment weighting (IPTW) was used to balance the baseline characteristics, and multivariable Cox regression models were used to estimate the hazard ratio (HR) with a 95% confidence interval (CI) for postoperative morbidity and mortality among the different anesthesia groups. A total of 45,874 patients were included in this study. Postoperative adverse events occurred in 1087 of 9864 patients (11.0%) who received neuraxial anesthesia and in 4635 of 36,010 patients (12.9%) who received general anesthesia. After adjustment for IPTW, the multivariable Cox regressions revealed that general anesthesia was associated with increased risks of postoperative morbidity (adjusted HR, 1.19; 95% CI, 1.14–1.24) and mortality (adjusted HR, 1.09; 95% CI, 1.03–1.16). The results of the present study suggest that, compared with general anesthesia, neuraxial anesthesia is associated with lower risks of postoperative adverse events in patients undergoing hip fracture surgery. |
| first_indexed | 2024-03-11T03:03:51Z |
| format | Article |
| id | doaj.art-a875ad3d682e45ff893d0aa9e4d921ef |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:03:51Z |
| publishDate | 2023-06-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a875ad3d682e45ff893d0aa9e4d921ef2023-11-18T08:06:58ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011211382710.3390/jcm12113827General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP DatabaseMing-Tse Wang0Chuen-Chau Chang1Chih-Chung Liu2Yu-Hsuan Fan Chiang3Yu-Ru Vernon Shih4Yuan-Wen Lee5Department of Anesthesiology, Taipei Medical University Hospital, Taipei 11031, TaiwanDepartment of Anesthesiology, Taipei Medical University Hospital, Taipei 11031, TaiwanDepartment of Anesthesiology, Taipei Medical University Hospital, Taipei 11031, TaiwanDepartment of Anesthesiology, Taipei Medical University Hospital, Taipei 11031, TaiwanDepartment of Orthopaedic Surgery, Duke University, Durham, NC 27708, USADepartment of Anesthesiology, Taipei Medical University Hospital, Taipei 11031, TaiwanWhether the use of neuraxial anesthesia or general anesthesia leads to more favorable postoperative outcomes in patients receiving hip fracture surgery remains unclear. We used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Data Files between 2016 and 2020 to investigate the association of neuraxial anesthesia and general anesthesia with morbidity and mortality after hip fracture surgery. Inverse probability of treatment weighting (IPTW) was used to balance the baseline characteristics, and multivariable Cox regression models were used to estimate the hazard ratio (HR) with a 95% confidence interval (CI) for postoperative morbidity and mortality among the different anesthesia groups. A total of 45,874 patients were included in this study. Postoperative adverse events occurred in 1087 of 9864 patients (11.0%) who received neuraxial anesthesia and in 4635 of 36,010 patients (12.9%) who received general anesthesia. After adjustment for IPTW, the multivariable Cox regressions revealed that general anesthesia was associated with increased risks of postoperative morbidity (adjusted HR, 1.19; 95% CI, 1.14–1.24) and mortality (adjusted HR, 1.09; 95% CI, 1.03–1.16). The results of the present study suggest that, compared with general anesthesia, neuraxial anesthesia is associated with lower risks of postoperative adverse events in patients undergoing hip fracture surgery.https://www.mdpi.com/2077-0383/12/11/3827hip fractureanesthesiapostoperative outcomespropensity scoremorbiditymortality |
| spellingShingle | Ming-Tse Wang Chuen-Chau Chang Chih-Chung Liu Yu-Hsuan Fan Chiang Yu-Ru Vernon Shih Yuan-Wen Lee General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP Database Journal of Clinical Medicine hip fracture anesthesia postoperative outcomes propensity score morbidity mortality |
| title | General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP Database |
| title_full | General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP Database |
| title_fullStr | General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP Database |
| title_full_unstemmed | General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP Database |
| title_short | General versus Neuraxial Anesthesia on Clinical Outcomes in Patients Receiving Hip Fracture Surgery: An Analysis of the ACS NSQIP Database |
| title_sort | general versus neuraxial anesthesia on clinical outcomes in patients receiving hip fracture surgery an analysis of the acs nsqip database |
| topic | hip fracture anesthesia postoperative outcomes propensity score morbidity mortality |
| url | https://www.mdpi.com/2077-0383/12/11/3827 |
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