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. 2022 May 1;36(5):234-238.
doi: 10.1097/BOT.0000000000002273.

Effects of Spinal Anesthesia in Geriatric Hip Fracture: A Propensity-Matched Study

Daniel L Rodkey  1 , Alexandra Pezzi  2 , Robert Hymes  3
Affiliations

Effects of Spinal Anesthesia in Geriatric Hip Fracture: A Propensity-Matched Study

Daniel L Rodkey et al. J Orthop Trauma. .

Abstract

Objectives: To identify whether anesthesia type is associated with surgical outcomes in geriatric patients undergoing operative treatment for a hip fracture.

Design: Retrospective database review of prospectively collected data.

Patients: Patients included in the American College of Surgeons National Surgical Quality Improvement Program database. All included patients were 65-89 years of age and had a hip fracture treated with internal fixation, arthroplasty, or intramedullary device. Patients were excluded for open, pathologic, stress-related, or periprosthetic hip fractures.

Intervention: Use of spinal anesthesia (SA) or general anesthesia (GA).

Main outcome measurements: Complications, mortality, and discharge destination.

Results: A total of 23,649 cases met inclusion and exclusion criteria and were successfully matched using propensity score matching: 15,766 GA and 7883 SA. The odds of sustaining a complication were 21% lower in the SA group compared with those in the GA group (odds ratio SA/GA 0.791; 95% confidence interval, 0.747-0.838). The 30-day mortality rate was not correlated with SA or GA choice. Patients who underwent SA were significantly more likely to be discharged to home (odds ratio SA/GA 1.65; 95% confidence interval, 1.531-1.773).

Conclusions: No mortality difference exists between patients undergoing SA and those undergoing GA for hip fracture surgery. For patients undergoing hip fracture surgery with SA, there is lower 30-day complication profile and higher discharge to home rate compared with those undergoing GA. Both anesthesia modalities may be acceptable.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

The authors report no conflict of interest.

References

    1. Hu F, Jiang C, Shen J, et al. Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury. 2012;43:676–685.
    1. Hamlet WP, Lieberman JR, Freedman EL, et al. Influence of health status and the timing of surgery on mortality in hip fracture patients. Am J Orthop Belle Mead NJ. 1997;26:621–627.
    1. Zuo D, Jin C, Shan M, et al. A comparison of general versus regional anesthesia for hip fracture surgery: a meta-analysis. Int J Clin Exp Med. 2015;8:20295–20301.
    1. Neuman MD, Silber JH, Elkassabany NM, et al. Comparative effectiveness of regional versus general anesthesia for hip fracture surgery in adults. Anesthesiology. 2012;117:72–92.
    1. Warren J, Sundaram K, Anis H, et al. Spinal anesthesia is associated with decreased complications after total knee and hip arthroplasty. J Am Acad Orthop Surg. 2020;28:e213–e221.