Similar mortality with general or regional anesthesia in elderly hip fracture patients
Background and purpose — There is continuing confusion among practitioners with regard to the optimal choice of anesthetic type for repair of hip fractures. We investigated whether type of anesthetic was associated with short-term mortality after hip fracture surgery. Patients and methods — We condu...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2016-03-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.3109/17453674.2015.1128781 |
| _version_ | 1818322647848583168 |
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| author | W Timothy Brox Priscilla H Chan Guy Cafri Maria C S Inacio |
| author_facet | W Timothy Brox Priscilla H Chan Guy Cafri Maria C S Inacio |
| author_sort | W Timothy Brox |
| collection | DOAJ |
| description | Background and purpose — There is continuing confusion among practitioners with regard to the optimal choice of anesthetic type for repair of hip fractures. We investigated whether type of anesthetic was associated with short-term mortality after hip fracture surgery. Patients and methods — We conducted a retrospective cohort study of patients with surgically treated hip fractures, performed between January 1, 2009 and December 31, 2012. Exposure of interest was anesthesia type (general, spinal/neuroaxial, and mixed). Endpoints were 30-, 90-, and 365-day post-surgery mortality. Multivariable conditional logistic regression models were used and odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Results — Of the 7,585 participants, 5,412 (71%) were women and the median age was 80 (IQR: 72–85) years old. Of the total cohort, 4,257 (56%) received general anesthesia, 3,059 (40%) received spinal/neuroaxial, and 269 (4%) received mixed anesthesia. Overall, the incidence of 30-, 90-, and 365-day mortality was 4% (n = 307), 8% (n = 583), and 15% (n = 1,126), respectively. When compared with general anesthesia, the 365-day odds of mortality was marginally lower in patients with spinal/neuroaxial anesthesia (OR = 0.84, CI: 0.70–1.0), but it was similar in patients with mixed anesthesia (OR = 1.3, CI: 0.70–2.3). No other statistically significant differences were observed. Interpretation — Regarding mortality, this study does not support specific recommendations regarding the type of anesthetic in surgery of fractured hips. |
| first_indexed | 2024-12-13T11:00:08Z |
| format | Article |
| id | doaj.art-d9c93c8e2a434f5f9467dc46cfed6976 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-13T11:00:08Z |
| publishDate | 2016-03-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-d9c93c8e2a434f5f9467dc46cfed69762022-12-21T23:49:19ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822016-03-0187215215710.3109/17453674.2015.11287811128781Similar mortality with general or regional anesthesia in elderly hip fracture patientsW Timothy Brox0Priscilla H Chan1Guy Cafri2Maria C S Inacio3The Permanente Medical Group, Kaiser Permanente, Kaiser Permanente, Kaiser Permanente, Kaiser PermanenteBackground and purpose — There is continuing confusion among practitioners with regard to the optimal choice of anesthetic type for repair of hip fractures. We investigated whether type of anesthetic was associated with short-term mortality after hip fracture surgery. Patients and methods — We conducted a retrospective cohort study of patients with surgically treated hip fractures, performed between January 1, 2009 and December 31, 2012. Exposure of interest was anesthesia type (general, spinal/neuroaxial, and mixed). Endpoints were 30-, 90-, and 365-day post-surgery mortality. Multivariable conditional logistic regression models were used and odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Results — Of the 7,585 participants, 5,412 (71%) were women and the median age was 80 (IQR: 72–85) years old. Of the total cohort, 4,257 (56%) received general anesthesia, 3,059 (40%) received spinal/neuroaxial, and 269 (4%) received mixed anesthesia. Overall, the incidence of 30-, 90-, and 365-day mortality was 4% (n = 307), 8% (n = 583), and 15% (n = 1,126), respectively. When compared with general anesthesia, the 365-day odds of mortality was marginally lower in patients with spinal/neuroaxial anesthesia (OR = 0.84, CI: 0.70–1.0), but it was similar in patients with mixed anesthesia (OR = 1.3, CI: 0.70–2.3). No other statistically significant differences were observed. Interpretation — Regarding mortality, this study does not support specific recommendations regarding the type of anesthetic in surgery of fractured hips.http://dx.doi.org/10.3109/17453674.2015.1128781 |
| spellingShingle | W Timothy Brox Priscilla H Chan Guy Cafri Maria C S Inacio Similar mortality with general or regional anesthesia in elderly hip fracture patients Acta Orthopaedica |
| title | Similar mortality with general or regional anesthesia in elderly hip fracture patients |
| title_full | Similar mortality with general or regional anesthesia in elderly hip fracture patients |
| title_fullStr | Similar mortality with general or regional anesthesia in elderly hip fracture patients |
| title_full_unstemmed | Similar mortality with general or regional anesthesia in elderly hip fracture patients |
| title_short | Similar mortality with general or regional anesthesia in elderly hip fracture patients |
| title_sort | similar mortality with general or regional anesthesia in elderly hip fracture patients |
| url | http://dx.doi.org/10.3109/17453674.2015.1128781 |
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