Why the study?
Does general anaesthesia increase postoperative mortality compared to spinal-epidural anaesthesia in patients older than 65 years undergoing surgery for hip fracture?
Does general anaesthesia increase postoperative mortality compared to spinal-epidural anaesthesia in patients older than 65 years undergoing surgery for hip fracture?
Age, general anaesthesia, and preoperative cardiac disease are significant independent risk factors for postoperative mortality in elderly patients undergoing hip fracture surgery.
General anaesthesia and preoperative cardiac disease were associated with higher mortality after elderly hip fracture repair; hypothesis-generating, should not yet change practice.
BACKGROUND: The aim of this study was to determine the factors affecting postoperative mortality in patients older than 65 years of age undergoing surgery for hip fracture. METHODS: A total of 308 patients (219 males and 89 females) were included into the study. Spinal-epidural anaesthesia was administered in 203 patients and general anaesthesia in 105 patients. In the evaluation of the patients regarding ASA, two groups were determined ASA 1-2 and ASA 3-4. Systemic diseases present in the patients were determined preoperatively. RESULTS: Seventy-seven (25%) of the total 308 patients died. In addition, patients with preoperative cardiac disease, patients on whom general anaesthesia was administered, patients in the ASA 3-4 group, and age were found to be significantly higher in mortality. When logistic regression analysis was performed for these four efficient factors, age, general anaesthesia, presence of cardiac disease were effective in mortality. However, ASA score changed depending on the age and cardiac disease. CONCLUSION: In case of presence of multiple risk factors, it is necessary to determine which factor is, in fact, more effective. Age, ASA score, type of anaesthesia, and presence of cardiac disease are effective in mortality. However, ASA score affects mortality depending on the cardiac disease and age.
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Karaman et al. (2015) studied this question.
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