Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2022; 10(9): 2721-2732
Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2721
Association between anesthesia technique and complications after hip surgery in the elderly population
Ling-Song Guo, Li-Nan Wang, Jian-Bing Xiao, Min Zhong, Gao-Feng Zhao
Ling-Song Guo, Li-Nan Wang, Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Jian-Bing Xiao, Min Zhong, Gao-Feng Zhao, Department of Anaesthesiology, Guangdong Provincial Hospital of Chinese Medicine (the Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou 510000, Guangdong Province, China
Author contributions: Guo LS and Wang LN contributed equally to this work; Guo LS, Wang LN, Zhao GF, Xiao JB, Zhong M designed research; Guo LS, Wang LN, Zhao GF performed research; Guo LS, Zhao GF, Xiao JB contributed new analytic tools; Guo LS and Wang LN analyzed data; Guo LS and Zhong M wrote the paper.
Institutional review board statement: The study was reviewed and approved by the [Ethics Committee of Guangdong Provincial Chinese Hospital, Guangzhou, China (Chairperson Prof J. Liu)] Institutional Review Board (Ethics approval number: ZE2020-288-01).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at email address. Participants gave informed consent was not obtained but the presented data are anonymized and risk of identification is low for data sharing.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gao-Feng Zhao, MD, Doctor, Department of Anaesthesiology, Guangdong Provincial Hospital of Chinese Medicine (the Second Affiliated Hospital of Guangzhou University of Chinese Medicine), No.111 Dade Road, Guangzhou 510000, Guangdong Province, China. zhaogaofengzyy@163.com
Received: October 10, 2021
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
ARTICLE HIGHLIGHTS
Research background

Successful surgery and postoperative functional recovery in the elderly remain challenging. Some studies believe that spinal anesthesia is superior to general anesthesia in surgery in the older patients. However, there is a lack of evidence on whether the selected anesthesia affects the complications after hip surgery in elderly patients.

Research motivation

The present study aimed to evaluate the effect of anesthesia on postoperative complications in older patients undergoing hip surgery.

Research objectives

Anesthesia technique is not a risk factor for postoperative complications of hip surgery, but it should be carefully selected for some patients.

Research methods

Patients included patients over 65 years old who underwent hip surgery in Traditional Chinese Medicine of Guangdong Provincial Hospital in China from October 2016 to June 2020. The main outcome of this study was postoperative complications during hospitalization. Hospital stay, postoperative blood transfusion, blood routine analysis, renal function, coagulation function and inflammation were secondary results. Propensity score matching was performed by logistic regression.

Research results

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 (P = 0.002) in spinal anesthesia group were significantly higher than those in general anesthesia group.

Research conclusions

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.

Research perspectives

To conclusively determine the preferred anesthesia for application in clinical hip arthroplasty practice, a multicenter, large-scale randomized trial is essential.