Anesthesia Technique, Mortality, and Length of Stay After Hip Fracture Surgery

Background There is no specific recommendation regarding the type of anaesthesia in hip fracture surgery. Objectives This study sought to examine the current local anaesthetic practice (general anaesthesia versus regional anaesthesia (RA)) in hip fracture surgery and to analyse their associations with perioperative outcomes. Methodology A retrospective observational study of hip fracture patients from April to December 2017 was undertaken. Patient characteristics and perioperative outcomes were analysed against the types of anaesthesia using multiple logistic regression. Results One hundred and twelve out of 154 patients (72.7%) had a general anaesthesia. Patients from residential care facilities were more likely to receive general anaesthesia (OR = 2.9, 95% CI: 1.1, 7.4; P = 0.03). There was no significant association between type of anaesthesia and specific postoperative outcomes; however, patients with postoperative delirium and hypotension were more likely to have received general anaesthesia [OR = 1.7, 95% CI: 0.68, 4.38; P = 0.25] and [OR = 1.6, 95% CI: 0.67, 4.04; P = 0.27] respectively). Subgroup analysis showed increased length of stay with patients who underwent general anaesthesia (OR = 1.26, 95% CI:1.04, 1.54; P = 0.02). Conclusion Regional anaesthesia may be considered in patients without contraindications in view of increased risk of postoperative delirium and hypotension, and longer length of stay with general anaesthesia. A larger prospective study is needed to confirm these findings.

Download Full-text

Impact of Diabetes Mellitus on Early Postoperative Outcomes After Hip Fracture Surgery in Geriatric Patients: A Retrospective, Propensity Score Matching Study

10.21203/rs.3.rs-141476/v1 ◽

2021 ◽

Author(s):

Ruibo Li ◽

Xingyue Yuan ◽

Yuehong Liu ◽

Shuping Liu ◽

Yu Zhou ◽

...

Keyword(s):

Diabetes Mellitus ◽

Hip Fracture ◽

Blood Transfusion ◽

Length Of Stay ◽

Propensity Score ◽

Propensity Score Matching ◽

Hospital Costs ◽

Hip Fracture Surgery ◽

Fracture Surgery ◽

Total Charges

Abstract Background：The impact of diabetes mellitus (DM) on hip fracture (HF) is still controversial. The primary aim of this study was to examine the influence of DM on perioperative transfusion， the secondary aims were to evaluate 1-year mortality, length of stay，and total charges in individuals with hip fracture.Methods: All patients with initial HF aged 60 years or older admitted to our hospital from January 2014 to January 2018 were eligible for this study. After excluding some patients who did not meet the experimental requirements, 326 HF patients aged 60 years and above were admitted to the study institution, and were divided into DM group (n=71) and non-diabetes mellitus (non-DM) group (n=255). Sex, age, American Society of Anesthesiologists (ASA) classification, anesthesia type and surgery type were matched in the two groups (DM group vs. non-DM group) using propensity score matching (PSM) without any statistical differences. Then，perioperative transfusion，length of stay，direct total charges and 1-year mortality in individuals with HF were compared between two groups.Results: Following PSM, 62 patients in the DM group and 62 patients in the non-DM group were included in the study. Twenty-eight patients had received blood transfusion during the perioperative period, the difference in blood transfusion rate between two groups was statistically significant (p=0.032). There were no statistical differences in 1-year mortality, length of stay and direct hospital costs between two groups.Conclusions: This study showed that DM patients with hip fractures have a higher probability of receiving transfusions compared to patients without DM. Higher blood transfusion rates may be associated with lower hemoglobin and hematocrit levels at admission. However, there was no significant increase in 1-year mortality, length of hospital stay, and direct hospital costs after hip fracture surgery due to diabetes.

Download Full-text