Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2721
Peer-review started: October 10, 2021
First decision: December 10, 2021
Revised: December 24, 2021
Accepted: February 12, 2022
Article in press: February 12, 2022
Published online: March 26, 2022
Processing time: 163 Days and 10.3 Hours
Spinal anesthesia is superior to general anesthesia for postoperative recovery in older patients (≥ 65 age). However, evidence for this is lacking.
To evaluate the effect of anesthesia on postoperative complications in older patients undergoing hip surgery.
This is a retrospective, propensity score-matched, cohort study. Patients ≥ 65-years-old who underwent hip surgery at the Traditional Chinese Medicine of Guangdong Provincial Hospital in China from October 2016 to June 2020 were included. The operative methods were femoral fracture’s internal fixation and hip replacement. The orthopedic doctors in different hospitals of our group have varied requirements for patients’ out-of-bed time after surgery. Therefore, spinal anesthesia or general anesthesia was selected according to the requirements of the orthopedic doctors. The primary outcome of this study was complications during the hospitalization of the postoperative patient. The length of hospital stay, postoperative blood transfusion, routine blood analysis, renal function, co
Among the 864 patients identified from the electronic medical record data database, we screened out those with incomplete medical record data. After PSM of the baseline values of the two groups of patients, data of 309 patients (206 patients in spinal anesthesia group and 103 patients in general anesthesia) were utilized in this study. 67/309 patients had complications, including postoperative limb dysfunction, pulmonary infection, delirium, lower extremity venous thrombosis, and shock. The incidence of complications was not related to anesthesia methods (P > 0.05), but the levels of D-Dimer (P = 0.017), fibrinogen (P = 0.005), and high-sensitivity C-reactive protein (hsCRP) (P = 0.002) in the spinal anesthesia group were significantly higher than those in the general anesthesia group.
Anesthesia technology is not a risk factor for postoperative complications of hip surgery. The levels of D-Dimer and hsCRP were higher in the spinal anesthesia group.
Core Tip: This is a retrospective cohort study. We used the propensity score matching to compare the preoperative data of retrospectively selected patients between groups. A total of 309 patients were selected to evaluate whether different anesthesia methods affect the incidence of postoperative complications of hip surgery in elderly patients. The current results showed no difference in postoperative complications between elderly patients undergoing hip surgery under spinal anesthesia and general anesthesia.