Key result
Regional anaesthesia was associated with a lower rate of blood transfusions compared to general anaesthesia in patients with hip fractures (19.8% vs 34.5%; OR 0.47, p < 0.05).
Why the study?
Surgical management of hip fractures often results in blood transfusions, and the relationship between anaesthetic modality, transfusion rates, and mortality in this population required examination.
Does regional anaesthesia reduce transfusion rates in patients with fracture neck of femur compared to general anaesthesia?
Cohort (n=280)
Does regional anaesthesia reduce transfusion rates in patients with fracture neck of femur compared to general anaesthesia?
Odds Ratio: 0.47
Absolute Event Rate: 19.8% vs 34.5%
p-value: p=< .05
Regional anaesthesia in hip fracture patients is associated with a halved risk of blood transfusion compared to general anaesthesia.
May support regional anaesthesia to reduce transfusions in hip fracture surgery; leaves open need for RCTs to confirm causality.
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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Gowers et al. (2021) conducted a cohort in Hip fracture (n=280). Regional anaesthesia vs. General anaesthesia was evaluated on Transfusion rates (OR 0.47, p=< .05). Regional anaesthesia was associated with a lower rate of blood transfusions compared to general anaesthesia in patients with hip fractures (19.8% vs 34.5%; OR 0.47, p < 0.05).
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