Key result
Regional anesthesia compared to general anesthesia showed no difference in postoperative morbidity and mortality in elderly patients undergoing hip surgery.
Why the study?
Hip surgeries in elderly patients involve significant physiological and surgical risks, motivating an evaluation of how age and anesthesia methods affect morbidity and mortality.
Does regional anesthesia reduce morbidity and mortality compared to general anesthesia in geriatric hip surgery patients?
Observational (n=258)
Does regional anesthesia reduce morbidity and mortality compared to general anesthesia in geriatric hip surgery patients?
In geriatric hip surgery patients, the choice between regional and general anesthesia does not significantly impact postoperative morbidity and mortality, which are primarily driven by advanced age and higher ASA scores.
Anesthesia choice was not associated with morbidity or mortality differences; leaves open whether RCTs would detect effects in geriatric hip surgery.
OBJECTIVES: Hip surgeries performed in elderly patients are important in terms of both the physiological features of geriatric patients and the risks of surgery. The aim of this study was to evaluate the effects of age and the anesthesia method used on morbidity and mortality in geriatric patients who had hip surgery. METHODS: Patients who were aged 65 and older who also had hip surgery and had American Society of Anesthesiologists (ASA) Physical Status Scale scores were included in the study. The patients were classified as aged (Group AG) for those ≥65 years of age, and very aged (Group VAG) for those ≥75 years of age. Details obtained from the hospital electronic records system of the patients' age, sex, ASA score, anesthesia method used, intraoperative and postoperative blood transfusion requirements, respiratory and cardiovascular complications, postoperative intensive care requirements, duration of hospital treatment, period of development of any postoperative complications, morbidity, and mortality were evaluated by age group. RESULTS: A total of 258 patients between the ages of 65 and 95 who had hip surgery and available ASA scores were included in the study. In Group VAG, the rate of morbidity and mortality of ASA III and IV patients was high in the postoperative period. Regional anesthesia methods were used more often in Group VAG patients, and there were more cardiovascular complications developing in the intraoperative period in the general anesthesia patients, although there was no difference between anesthesia methods in terms of postoperative morbidity and mortality. CONCLUSION: In this study of elderly patients who had hip surgery, there was no correlation between the anesthesia method used and morbidity and mortality. Advanced age (≥75 years) and a high ASA score were the most important risk factors for mortality.
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Sema Şanal Baş (2019) conducted an observational in Geriatric hip surgery (n=258). Regional anesthesia vs. General anesthesia was evaluated on Postoperative morbidity and mortality. Regional anesthesia compared to general anesthesia showed no difference in postoperative morbidity and mortality in elderly patients undergoing hip surgery.
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