Regional Anesthesia Linked to Better Hip Fracture Outcomes
(HealthDay News) – Regional anesthesia is associated with a lower risk of death and pulmonary complications compared with general anesthesia in patients undergoing surgery for hip fracture, with improved outcomes specific to patients with intertrochanteric fractures, according to a study published in the July issue of Anesthesiology.
Mark D. Neuman, MD, from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues retrospectively examined the association of regional versus general anesthesia with outcomes in 18,158 patients who underwent surgery for hip fracture. Of these, 29% received regional anesthesia (epidural, spinal, or nerve block).
The researchers found that, compared with general anesthesia, regional anesthesia was associated with a significantly lower adjusted risk of mortality (adjusted odds ratio, 0.71) and with fewer pulmonary complications (adjusted odds ratio, 0.752). These lower risks were specific to patients with intertrochanteric fractures but not femoral neck fractures.
"Our findings suggest that management of hip fracture surgery employing regional anesthesia may offer benefits in terms of inpatient mortality and respiratory complications, and that these benefits may vary according to fracture type," Neuman and colleagues conclude. "Given the high rate of mortality associated with hip fracture, as well as the large and growing worldwide public health burden attributed to complications of hip fracture care, our findings highlight a potential opportunity to improve outcomes among a growing population of vulnerable surgical patients."