Impact of maternal age on delivery outcomes following spontaneous labour at term

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Edwin Eseoghene Omih ◽  
Stephen Lindow
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Maternal Age ◽  
Outcome Measure ◽  
Statistical Significance ◽  
Perineal Trauma ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Assisted Vaginal Delivery ◽  
The Impact

AbstractAim:Pregnancy in women of advancing maternal age is linked to incrementally worsening perinatal outcome. The aim of this study is to assess the impact of maternal age on delivery outcome in women that spontaneously labour at term.Methods:This was a retrospective study of women that spontaneously labour at term. Women with singletons in spontaneous onset labour beyond 37 weeks of gestation were divided into five maternal age groups: <19 years, 20–24 years, 25–29 years, 30–34 years and >35 years by their age at delivery. The main outcome variables are augmentation of labour, caesarean section, assisted vaginal delivery, and perineal trauma, while admission of the newborn into the neonatal unit within 24 h following delivery was the secondary outcome measure.Results:A total of 30,022 met the inclusion criteria with primiparae and multiparae accounting for 46 and 54%, respectively. Increasing age in primiparae was associated with; augmentation of labour OR 2.05 (95% CI 1.73–2.43), second degree perineal tear 1.35 (1.12–1.61), assisted vaginal delivery 1.92 (1.53–2.41) and caesarean section 4.23 (3.19–5.12). While that for multiparae; augmentation of labour OR 1.93 (1.05–3.52), perineal trauma 2.50 (1.85–3.34), assisted vaginal delivery 4.95 (91.82–13.35) and caesarean section 1.64 (1.13–2.38). The secondary outcome measure did not reach statistical significance.Conclusion:Increasing maternal age is an independent risk factor for operative delivery, and perineal trauma. However, maternal age has no significant effect on admission of infants into the NICU during the first 24 h following delivery.

The effect of ICSI-related procedural timings and operators on the outcome

2020 ◽  
Vol 35 (1) ◽  
pp. 32-43 ◽  
Author(s):  
Roberta Maggiulli ◽  
Danilo Cimadomo ◽  
Gemma Fabozzi ◽  
Letizia Papini ◽  
Lisa Dovere ◽  
...  
Keyword(s):  
Maternal Age ◽  
Outcome Measure ◽  
Delivery Rate ◽  
Secondary Outcome ◽  
Daily Routine ◽  
Secondary Outcome Measure ◽  
Induction Of Ovulation ◽  
The Mean ◽  
Blastulation Rate

Abstract STUDY QUESTION Do the ICSI-related procedural timings and operators affect the outcomes of an ART cycle? SUMMARY ANSWER The ICSI-related timings and operators do not associate with the mean blastulation rate per cohort of inseminated oocytes and the cumulative delivery rate per concluded cycle, except for a mild association between the times from induction of ovulation to oocyte denudation and the former outcome. WHAT IS KNOWN ALREADY In ART, specific timings, protocols and conditions must be complied with to preserve gamete developmental and reproductive competence during the required manipulations. ICSI represents a groundbreaking advancement that has been widely implemented. Nevertheless, the studies that examined the putative impact of ICSI-related procedural timings were mainly conducted in old-fashioned settings or in good prognosis patients. No report addressed issues like operators’ skills and experience and uncertainties exist dealing with the effect of cumulus cells in the pre-incubation period in vitro before ICSI. However, all this information is crucial to efficiently plan the daily routine of an IVF lab, fill the existing gaps of knowledge and define proper key performance indicators. STUDY DESIGN, SIZE, DURATION Observational study conducted at a private IVF clinic (January 2016 to January 2018). We included all consecutive ICSI procedures (n = 1084 infertile couples undergoing 1444 cycles with or without preimplantation genetic testing (PGT); mean ± SD maternal age: 38.1 ± 4.0 years) with fresh autologous oocytes (n = 7999 oocytes, 5.5 ± 3.2 per treatment) inseminated with fresh non-donor ejaculated sperm. All operators and critical procedural timings (induction of ovulation to oocyte denudation, denudation and ICSI) were automatically recorded through an electronic witnessing system. The primary outcome measure was the cumulative delivery rate among both non-PGT and PGT-concluded cycles (i.e. delivery achieved or no supernumerary cryopreserved blastocyst available). The secondary outcome measure was the mean blastulation rate per cohort of inseminated oocytes. All confounders were registered and included in generalized linear models and multivariate logistic regression analyses. PARTICIPANTS/MATERIALS, SETTING, METHODS Fourteen and 12 operators were involved in denudation and ICSI procedures, respectively. Denudation was performed after 4.1 ± 1.2 h (2–7) of pre-incubation in vitro after oocyte retrieval, and ICSI was started immediately after. Beyond procedural timings and operators, all the putative confounders (patients’ and cycles’ characteristics) on the primary and/or secondary outcomes were systematically registered and included in the statistical analyses. MAIN RESULTS AND THE ROLE OF CHANCE The mean time from induction of ovulation to oocyte denudation was 39.3 ± 1.3 h. The mean procedural timings for denudation and ICSI were 8.1 ± 3.8 and 12.6 ± 6.4 min; both these variables were significantly dependent on the number of inseminated oocytes and the operators’ skills and experience. The overall mean blastulation rate per cohort of inseminated oocytes was 34.0 ± 27.9%. This outcome was significantly associated with the time from induction of ovulation to oocyte denudation (mean blastulation rate stable in the time interval 38–42 h, but significantly higher for timings &lt;38 h), maternal age (the mean blastulation rate drops especially beyond the age of 40 years) and categorized sperm concentration (highest mean blastulation rate for sperm concentrations ≥15 mil/ml and lowest for cryptozoospermic patients) through a generalized linear model that showed an adjusted r2 = 0.053 (P &lt; 0.01). No association was found for denudation and ICSI timings and operators. Lastly, when adjusted for maternal age and number of inseminated oocytes, both ICSI-related procedural timings and operators did not associate with the cumulative delivery rate among both non-PGT- or PGT-concluded cycles. LIMITATIONS, REASONS FOR CAUTION This is a single private IVF center study. Its reproducibility should be assessed in different laboratory conditions, with different protocols and in the hands of different operators. Moreover, specific studies are warranted to address the beneficial/detrimental effect of the other putative confounders under investigation (e.g. kind of ovulation trigger, culture media, incubator, etc.). WIDER IMPLICATIONS OF THE FINDINGS Proactive communication between the embryologists and the clinicians might contribute to a reasoned and more efficient organization of the daily workload and increase the mean blastulation rate, especially when poor prognosis couples (advanced maternal age, reduced sperm count and/or ovarian reserve) are treated. STUDY FUNDING/COMPETING INTEREST(S) No funding. The authors declare no conflict of interest related to the present study.

Effects of greens+® A Randomized, Controlled Trial

2004 ◽  
Vol 65 (2) ◽  
pp. 66-71 ◽  
Author(s):  
Heather Boon ◽  
Joyce Clitheroe ◽  
Tonia Forte
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Outcome Measure ◽  
Statistical Significance ◽  
Treatment Protocol ◽  
Secondary Outcome ◽  
Controlled Clinical Trial ◽  
Secondary Outcome Measure ◽  
Female Population ◽  
Study Objective

Greens+® is a popular natural health product marketed as energy-enhancing; however, no objective data substantiate this claim. The study objective was to determine if ingestion of greens+® 1. increases vitality, energy, and perception of wellbeing; 2. increases overall mental health and general health, and 3. decreases the incidence of colds and flus in an otherwise healthy female population. A total of 105 women were enrolled in this 12-week, randomized, double-blind, placebo-controlled clinical trial; 63 (60%) completed the treatment protocol. Both treatment and placebo groups showed a significant time trend effect, scoring better on all outcome measures as the trial progressed. Compared with the placebo group, the greens+® group scored marginally higher on vitality, the primary outcome measure (p=0.055), and significantly higher on energy (a secondary outcome measure, p=0.018). Findings were based on repeated measures analysis of variance; baseline scores were used as covariates. Although a trend toward greater improvement in the greens+® group was noted in the other secondary outcome measures, this trend did not reach statistical significance. Overall, our findings were positive but not conclusive that greens+® increases vitality and energy. These results provide justification for further study of the effects of greens+®.

Insurance Status and Survival of Patients with Salivary Gland Cancer

2018 ◽  
Vol 159 (6) ◽  
pp. 998-1005 ◽  
Author(s):  
Anirudh Saraswathula ◽  
Uchechukwu C. Megwalu
Keyword(s):  
Salivary Gland ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Salivary Gland Cancer ◽  
Insurance Status ◽  
Secondary Outcome Measure ◽  
Major Salivary Gland ◽  
Insured Patients ◽  
The Impact

Objectives To evaluate the impact of insurance status on survival among patients with major salivary gland cancer. Study Design Retrospective cohort study. Setting SEER program. Subjects and Methods We included patients aged <65 years diagnosed with major salivary gland cancers from 2007 to 2013. Those aged ≥65 years were excluded due to issues ascertaining insurance status. The independent variable was insurance status (insured, uninsured, or Medicaid); the primary outcome measure was overall survival (OS); and the secondary outcome measure was disease-specific survival (DSS). Results Compared with insured patients, uninsured and Medicaid patients were more likely to present with stage III-IV disease (uninsured: odds ratio [OR], 1.57; 95% CI, 1.09-2.27; Medicaid: OR, 1.67; 95% CI, 1.27-2.20) and with distant metastasis (uninsured: OR, 2.10; 95% CI, 1.18-3.57; Medicaid: OR, 1.96; 95% CI, 1.25-3.01) after adjusting for demographic and tumor variables. Uninsured and Medicaid patients also had worse OS (uninsured: hazard ratio [HR], 1.62; 95% CI, 1.14-2.29; Medicaid: HR, 1.74; 95% CI, 1.33-2.38) and DSS (uninsured: HR, 1.57; 95% CI, 1.08-2.29; Medicaid: HR, 1.68; 95% CI, 1.25-2.25) after adjusting for demographic and tumor variables. After further adjusting for treatment variables, only Medicaid status was significantly associated with worse OS (HR, 1.71; 95% CI, 1.30-2.26) and DSS (HR, 1.65; 95% CI, 1.23-2.23). Conclusions Insurance status is associated with stage at presentation and survival among patients with salivary gland cancer.

scholarly journals O4 Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Samuel Lawday ◽  
Isobel Trout
Keyword(s):  
Cohort Study ◽  
Outcome Measure ◽  
Elective Surgery ◽  
Postoperative Mortality ◽  
Postoperative Recovery ◽  
Pulmonary Complications ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Complication Rates ◽  
The Impact

Abstract Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery is poorly understood. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality. The secondary outcome measure was pulmonary complications (pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation). Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p &lt; 0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p &lt; 0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p &lt; 0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p = 0·046), emergency versus elective surgery (1·67 [1·06–2·63], p = 0·026), and major versus minor surgery (1·52 [1·01–2·31], p = 0·047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than normal practice, particularly in men aged 70 years and older.

scholarly journals Seizure outcome in temporal glioblastoma surgery: lobectomy as a supratotal resection regime outclasses conventional gross-total resection

2021 ◽  
Author(s):  
Valeri Borger ◽  
Motaz Hamed ◽  
Inja Ilic ◽  
Anna-Laura Potthoff ◽  
Attila Racz ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Temporal Lobectomy ◽  
Secondary Outcome ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Secondary Outcome Measure ◽  
Total Resection ◽  
Class 1 ◽  
Postoperative Seizure ◽  
The Impact

Abstract Introduction The postoperative seizure freedom represents an important secondary outcome measure in glioblastoma surgery. Recently, supra-total glioblastoma resection in terms of anterior temporal lobectomy (ATL) has gained growing attention with regard to superior long-term disease control for temporal-located glioblastoma compared to conventional gross-total resections (GTR). However, the impact of ATL on seizure outcome in these patients is unknown. We therefore analyzed ATL and GTR as differing extents of resection in regard of postoperative seizure control in patients with temporal glioblastoma and preoperative symptomatic seizures. Methods Between 2012 and 2018, 33 patients with preoperative seizures underwent GTR or ATL for temporal glioblastoma at the authors’ institution. Seizure outcome was assessed postoperatively and 6 months after tumor resection according to the International League Against Epilepsy (ILAE) classification and stratified into favorable (ILAE class 1) versus unfavorable (ILAE class 2–6). Results Overall, 23 out of 33 patients (70%) with preoperative seizures achieved favorable seizure outcome following resection of temporal located glioblastoma. For the ATL group, postoperative seizure freedom was present in 13 out of 13 patients (100%). In comparison, respective rates for the GTR group were 10 out of 20 patients (50%) (p = 0.002; OR 27; 95% CI 1.4–515.9). Conclusions ATL in terms of a supra-total resection strategy was associated with superior favorable seizure outcome following temporal glioblastoma resection compared to GTR. Regarding above mentioned survival benefit following ATL compared to GTR, ATL as an aggressive supra-total resection regime might constitute the surgical modality of choice for temporal-located glioblastoma.

scholarly journals Evaluation of Pregnancy Outcomes at Advanced Maternal Age

2019 ◽  
Vol 7 (12) ◽  
pp. 1951-1956 ◽  
Author(s):  
Małgorzata Radoń-Pokracka ◽  
Beata Adrianowicz ◽  
Magdalena Płonka ◽  
Paulina Danił ◽  
Magdalena Nowak ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Maternal Age ◽  
Statistical Significance ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
Large For Gestational Age ◽  
Predisposing Factor ◽  
Over 40 Years

AIM: The study aimed to investigate the association between advanced maternal age (AMA) and the risk of adverse maternal, perinatal and neonatal outcomes about parity in singleton pregnancies.METHODS: We retrospectively analysed 950 women who gave birth in the Department of Obstetrics and Perinatology of the University Hospital in Kraków for six months (between 1st January and 30th June 2018). The patients were divided into 3 groups according to their age (30-34 years old, 35-39 years old and over 40 years old). Each of these groups was subsequently subdivided into 2 groups depending on parity (primiparae and multiparae). Maternal, perinatal and neonatal outcomes were compared between the groups and the subgroups.RESULTS: Comparison of the three age groups revealed that advanced maternal age might constitute a predisposing factor for preterm birth, caesarean section and large for gestational age (LGA). From these parameters, statistical significance was reached in case of greater risk of LGA (OR = 2.17), caesarean section (OR = 2.03) and elective C-section (OR = 1.84) in women over 40 years old when compared to the patients aged 30-34. Furthermore, AMA increases the risk of postpartum haemorrhage (OR = 6.43). Additionally, there is a negative correlation between maternal age and gestational age at delivery (R = -0.106, p < 0.05).CONCLUSIONS: Advanced maternal age can undoubtedly be associated with several adverse perinatal outcomes. At the same time, the risk of perinatal complications begins to increase after the age of 35 but becomes significant in women aged ≥ 40.

scholarly journals Success of trabeculectomy surgery in relation to cataract surgery: 5-year outcomes

2018 ◽  
Vol 103 (10) ◽  
pp. 1395-1400 ◽  
Author(s):  
Rashmi G Mathew ◽  
Sahar Parvizi ◽  
Ian E Murdoch
Keyword(s):  
Cataract Surgery ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Risk Of Failure ◽  
Increased Risk ◽  
Significant Difference ◽  
Measure Change ◽  
Group 2

AimsTo compare success proportions at 5 years in three surgical groups: group 1, trabeculectomy alone; group 2, trabeculectomy followed by cataract surgery within 2 years; and group 3, trabeculectomy performed on a pseudophakic eye.MethodsA retrospective cohort study. 194 eyes of 194 patients were identified with at least 5 years’ follow-up post trabeculectomy (N=85, 60 and 49 in groups 1, 2 and 3, respectively).Main outcome measures1. Primary outcome measure: intraocular pressure (IOP) at 5 years post-trabeculectomy surgery, 2.Secondary outcome measure: change in visual acuity at 5 years.ResultsAt 5 years, the mean IOP (SD) was 12.9 (3.5), 12.5 (4.8) and 12.7 (4.8) mm Hg in groups 1, 2 and 3, respectively. Overall success was almost identical, 58%, 57% and 59% in groups 1, 2 and 3, respectively. There was no significant difference between the groups in terms of percentage IOP reduction, number of medications, proportion restarting medication and reoperation rates at 5 years. Logistic regression for an outcome of failure showed men to be at increased risk of failure OR 1.97 (95% CI 1.10 to 3.52, p=0.02). Nearly 80% of patients retained or improved their vision following their initial trabeculectomy.ConclusionsThe sequence in which surgery is carried out does not appear to affect trabeculectomy function at 5 years, success being similar to trabeculectomy alone. In our study, men may be at increased risk of failure.

scholarly journals A new antibiotic stewardship program approach is effective on inappropriate surgical prophylaxis and discharge prescription

2019 ◽  
Vol 13 (11) ◽  
pp. 961-967 ◽  
Author(s):  
Cem Karaali ◽  
Mustafa Emiroglu ◽  
Sabri Atalay ◽  
Ismail Sert ◽  
Ayberk Dursun ◽  
...  
Keyword(s):  
Antibiotic Prescription ◽  
Statistical Significance ◽  
Compliance Rate ◽  
Prophylactic Antibiotic ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Stewardship Program ◽  
Surgical Antibiotic Prophylaxis ◽  
Clean Contaminated

Introduction: This study aims to evaluate the efficacy of a new antimicrobial stewardship program (ASP) on surgical antibiotic prophylaxis (SP) and antibiotics in discharge prescriptions used as a continuation of SP. Methodology: The study included elective patients with clean and clean-contaminated wounds. The accuracy of the assigned SP was evaluated according to international guidelines. Primary outcome measures comprised appropriateness of prophylactic antibiotic indication, correct timing of initial dose, discontinuation of SP within 24 hours, and antibiotic prescription at discharge. A secondary outcome measure was to determine whether the effect of ASP was sustained long-term. Results: The total compliance rate for all stages of SP increased from 8% to 52.1% after the intervention (p < 0.05). When analyzed according to individual SP components, it was found that although ASP did not change first dose timing rates, it did affect the rates of prophylactic antibiotic indication, discontinuation of SP within 24 hours and antibiotic prescription at discharge, with statistical significance (p < 0.05). In addition, ASP continued to increase its effectiveness throughout the 3rd year. Conclusions: Based on the findings of our study, it seems clear that the modified ASP introduced in our general surgery clinic can be used effectively and simply; in addition, this ASP increases its efficacy with time.

scholarly journals Determinants of Sports Injury in Young Female Swedish Competitive Figure Skaters

2021 ◽  
Vol 3 ◽  
Author(s):  
Moa Jederström ◽  
Sara Agnafors ◽  
Christina Ekegren ◽  
Kristina Fagher ◽  
Håkan Gauffin ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Sports Injury ◽  
Young Female ◽  
Older Age ◽  
Point Prevalence ◽  
Severe Injury ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Multiple Model ◽  
Figure Skaters

Introduction: Although figure skating attracts several hundred thousand participants worldwide, there is little knowledge about physical health and sports injuries among young skaters. The present study aimed to describe the health status of a geographically defined Swedish population of licensed competitive figure skaters and to examine injury determinants.Methods: All licensed competitive skaters in the southeastern region of Sweden were in April 2019 invited to participate in a cross-sectional study using an online questionnaire. Multiple binary logistic regression was used for the examination of injury determinants. The primary outcome measure was the 1-year prevalence of a severe sports injury episode (time loss &gt;21 days). The secondary outcome measure was the point prevalence of an ongoing injury. The determinants analyzed were age, skating level, relative energy deficiency indicators, and training habits.Results: In total, 142 (36%) skaters participated, 137 (96%) girls [mean (SD) age: 12.9 (SD 3.0) years]. Participating boys (n = 5) were excluded from further analysis. The 1-year prevalence of a severe sports injury episode was 31%. The most common injury locations for these injuries were the knee (25%), ankle (20%), and hip/groin (15%). In the multiple model, having sustained a severe injury episode was associated with older age (OR 1.2, 95% CI 1.1–1.4; p = 0.002) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.014). The point prevalence of an ongoing injury episode was 19%. The most common locations were the knee (24%), ankle (24%), and foot (24%). Having an ongoing injury episode was associated with older age (OR 1.4, 95% CI 1.2–1.7; p &lt; 0.001) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.049).Conclusion: One-third of young female Swedish competitive figure skaters had sustained a severe injury episode during the past year, and a fifth reported an ongoing episode. Older age and an increased number of skipped meals per week were associated with a sports injury episode. Long-term monotonous physical loads with increasing intensity and insufficient energy intake appear to predispose for injury in young female figure skaters. Further examination of injury determinants among competitive figure skaters is highly warranted.

The importance of perioperative optimisation to facilitate safe regional anaesthesia and their improved outcomes in fracture neck of femur patients

2021 ◽  
pp. 175045892110640
Author(s):  
Benjamin Thomas Vincent Gowers ◽  
Michael Sean Greenhalgh ◽  
Kathryn Dyson ◽  
Karthikeyan P Iyengar ◽  
Vijay K Jain ◽  
...  
Keyword(s):  
Hip Fracture ◽  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
General Anaesthetic ◽  
Secondary Outcome Measure ◽  
Neck Of Femur ◽  
One Year ◽  
To Receive

Background: Hip fractures are common presentations to orthopaedic departments, and their surgical management often results in blood transfusions. Compared with general anaesthesia, regional anaesthesia reduces the need for transfusions and mortality in the wider surgical population. Aims: In hip fracture patients, our primary outcome measure was to examine any relationship between anaesthetic modality and transfusion rates. The secondary outcome measure was to assess the relationship between anaesthetic modality and one-year mortality. Methods: A retrospective cohort study of 280 patients was carried out in 2017 and 2018. Data were collected from patient records, local transfusion laboratory and the national hip fracture database. Results: A total of 59.6% had regional and 40.4% general anaesthesia. Regional anaesthesia patients were younger with fewer comorbidities (p < .05). About 19.8% regional and 34.5% general anaesthesia patients received transfusions (odds ratio (OR) = 0.47, p < .05); 13.6% were taking anticoagulants and were less likely to receive a regional anaesthetic (31.6% versus 64%, OR = 0.26, p < .05). One-year mortality was 27% for regional and 37% for general anaesthetic patients (OR = 0.64, p = .09). Conclusion: Regional anaesthesia halved the risk of blood transfusion. Anticoagulated patients were 74% less likely to receive regional anaesthetics, but had no additional transfusion risk. With optimisation, a larger proportion of patients could have regional anaesthesia.

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