Researchers conducted a retrospective cohort study reviewing data on 16,695 patients, 65 years and older, from 38 U.S.-based facilities. The patients underwent emergent hip fracture repairs between 2009 and 2014 receiving either general anesthesia, regional anesthesia or intraoperative conversions from regional to general.
Here’s what they found.
1. Compared with regional anesthesia, the inpatient mortality hazard ratio rate was 1.38 for general anesthesia and was 2.23 for the intraoperative conversions group.
2. Time ratio for general anesthesia-associated time to death was higher at 0.97 compared to a rate of 0.89 for the intraoperative conversions group.
3. General anesthesia associated time ratio for length of stay before discharge was 1.01 days and the hazard ratio for home discharge was 0.89, both higher than regional anesthesia rates.
Researchers concluded, “Regional anesthesia may offer advantages over general anesthesia for fragility hip fracture surgery when possible. In-hospital mortality, time to death, increased length of stay and discharge to an institute rather than home were all adversely influenced by general anesthesia. Furthermore, the previously understudied [intraoperative conversions] group demonstrated adverse outcomes for in-hospital mortality and time to death.
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