Long-term outcome after repair of fractured neck of femur. Comparison of subarachnoid and general anaesthesia

Abstract

One hundred and forty-eight patients undergoing "pin-and-plate" repair of fractured neck of femur received either subarachnoid blockade or general anaesthesia. The patients were followed up for 1 year after surgery. At the end of the year, 34% had died and 50% had returned home. Twelve per cent were either in hospital or in institutional care; 4% were lost to follow up. The mean duration of acute plus convalescent hospital bed occupancy was 84.4 days. There was a significantly lower mortality in the subarachnoid anaesthetic group by 14 days after surgery. The majority of the deaths in the general anaesthetic group were clustered between 6 and 16 days. However, at the end of 2 months the mortality rates were similar in both groups. It is conceivable that the difference in the distribution of deaths between the groups was a result of thrombo-embolism.