Literature DB >> 33716444

Comparative outcome of anaesthetic for elderly hip fracture.

Vipul Garg1, Hayley Lawrence1, Yogesh Joshi1.   

Abstract

PURPOSE: Current guidelines recommend offering patients both options of a spinal or general anaesthetic. At local level we attempt to ensure whether similar outcome is reflected in our practice regarding difference between General anaesthesia(GA) and Spinal Anaesthesia(SA) in morbidity and mortality.
METHODS: Data from spreadsheet maintained for NHFD was used to identify patients with Neck of Femur Fracture in 2018.Mortality data was retrieved from the Welsh Clinical Portal. Data was organised according to the type of anaesthetic received. Outcome measures for Morbidity (length of stay in hospital) and Mortality (at both 30 days and 120 days) following surgery, were then inputted for these patients. Statistical analysis was performed using SPSS software. A Mann Whitney U Test was performed for length of stay and Kaplan-Meier Estimates for survival at 30 and 120 days. Log Rank (Mantel Cox) Hypothesis Test is used to compare mortality between two Anaesthetic groups.
RESULTS: We reviewed 203 patients elderly hip fracture with mean age of 83 (range 60-99), there were 142 Female and 61 males.4 patients were treated non operatively, and 2 patients had no data available 0.146 patient received GA and 46 received spinal anaesthesia. Hemiarthroplasty and DHS are commonest procedure in both groups. On applying Mann Whitney U test There is no statistical difference between the length of stay There is no statistical difference between the length of stay for SA and GA Patients. (p = 0.483). for SA and GA Patients (p = 0.483). On APPLYING Log Rank (Mantel-Cox) Analysis there is no statically difference in mortality at 30 days and 120 days with p value 0.087 and 0.397 respectively.
CONCLUSION: In summary, this audit remains in line with current literature, that there is not a significant difference between the length of stay, survival at 30 days and at 120 days between the two different groups.
© 2020 Delhi Orthopedic Association. All rights reserved.

Entities:  

Keywords:  General anaesthesia; Morbidity; Mortality; Neck of femur fracture; Spinal anaesthesia

Year:  2020        PMID: 33716444      PMCID: PMC7920336          DOI: 10.1016/j.jcot.2020.06.016

Source DB:  PubMed          Journal:  J Clin Orthop Trauma        ISSN: 0976-5662


  13 in total

1.  Nottingham Hip Fracture Score: longitudinal and multi-assessment.

Authors:  I K Moppett; M Parker; R Griffiths; T Bowers; S M White; C G Moran
Journal:  Br J Anaesth       Date:  2012-06-22       Impact factor: 9.166

2.  Projected incidence of proximal femoral fracture in England: a report from the NHS Hip Fracture Anaesthesia Network (HIPFAN).

Authors:  S M White; R Griffiths
Journal:  Injury       Date:  2010-12-22       Impact factor: 2.586

Review 3.  Hip fracture.

Authors:  Martyn Parker; Antony Johansen
Journal:  BMJ       Date:  2006-07-01

4.  The National Joint Registry may fail to collect accurate, validated anaesthetic data.

Authors:  B W Howes; P A Clarke; T M Cook
Journal:  Anaesthesia       Date:  2009-06       Impact factor: 6.955

Review 5.  Neuroaxial versus general anaesthesia in geriatric patients for hip fracture surgery: does it matter?

Authors:  T J Luger; C Kammerlander; M Gosch; M F Luger; U Kammerlander-Knauer; T Roth; J Kreutziger
Journal:  Osteoporos Int       Date:  2010-11-06       Impact factor: 4.507

6.  Comparative effectiveness of regional versus general anesthesia for hip fracture surgery in adults.

Authors:  Mark D Neuman; Jeffrey H Silber; Nabil M Elkassabany; Justin M Ludwig; Lee A Fleisher
Journal:  Anesthesiology       Date:  2012-07       Impact factor: 7.892

7.  Outcome by mode of anaesthesia for hip fracture surgery. An observational audit of 65 535 patients in a national dataset.

Authors:  S M White; I K Moppett; R Griffiths
Journal:  Anaesthesia       Date:  2014-01-15       Impact factor: 6.955

8.  Patient risk factors, operative care, and outcomes among older community-dwelling male veterans with hip fracture.

Authors:  Tiffany A Radcliff; William G Henderson; Tamara J Stoner; Shukri F Khuri; Michael Dohm; Evelyn Hutt
Journal:  J Bone Joint Surg Am       Date:  2008-01       Impact factor: 5.284

Review 9.  General vs. neuraxial anaesthesia in hip fracture patients: a systematic review and meta-analysis.

Authors:  Julia Van Waesberghe; Ana Stevanovic; Rolf Rossaint; Mark Coburn
Journal:  BMC Anesthesiol       Date:  2017-06-28       Impact factor: 2.217

10.  Comparative safety of anesthetic type for hip fracture surgery in adults: retrospective cohort study.

Authors:  Elisabetta Patorno; Mark D Neuman; Sebastian Schneeweiss; Helen Mogun; Brian T Bateman
Journal:  BMJ       Date:  2014-06-27
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