Comparative Effectiveness of Regional versus General Anesthesia for Hip Fracture Surgery in Adults

@article{Neuman2012ComparativeEO,
  title={Comparative Effectiveness of Regional versus General Anesthesia for Hip Fracture Surgery in Adults},
  author={Mark D. Neuman and Jeffrey H Silber and Nabil M. Elkassabany and Justin Michael Ludwig and Lee A. Fleisher},
  journal={Anesthesiology},
  year={2012},
  volume={117},
  pages={72–92}
}
Background: Hip fracture is a common, morbid, and costly event among older adults. Data are inconclusive as to whether epidural or spinal (regional) anesthesia improves outcomes after hip fracture surgery. Methods: The authors examined a retrospective cohort of patients undergoing surgery for hip fracture in 126 hospitals in New York in 2007 and 2008. They tested the association of a record indicating receipt of regional versus general anesthesia with a primary outcome of inpatient mortality… 
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Comparative safety of anesthetic type for hip fracture surgery in adults: retrospective cohort study
TLDR
Mortality risk did not differ significantly by anesthesia type among patients undergoing hip fracture surgery, suggesting that if the previously posited beneficial effect of regional anesthesia on short term mortality exists, it is likely to be more modest than previously reported.
A comparison of general versus regional anesthesia for hip fracture surgery: a meta-analysis.
TLDR
It was found that the 30-day mortality rate was lower in general anesthesia cases than that in regional cases, indicating that types of anesthesia might not be a risk factor for hip fracture surgery.
Similar mortality with general or regional anesthesia in elderly hip fracture patients
TLDR
A retrospective cohort study of patients with surgically treated hip fractures, performed between January 1, 2009 and December 31, 2012, finds that type of anesthetic was associated with short-term mortality after hip fracture surgery but does not support specific recommendations regarding the type ofanesthetic in surgery of fractured hips.
Anesthesia technique, mortality, and length of stay after hip fracture surgery.
TLDR
Among adults in acute care hospitals in New York State undergoing hip repair, the use of regional anesthesia compared with general anesthesia was not associated with lower 30-day mortality but was associated with a modestly shorter length of stay.
The Effect of Anesthetic Type on Outcomes of Hip Fracture Surgery
TLDR
Regional anesthesia is not associated with 30-day mortality, but is associated with lower 30- day all-cause and surgical site infection readmission compared with general anesthesia for hip fracture surgery.
Impact of Anesthesia on Hospital Mortality and Morbidities in Geriatric Patients Following Emergency Hip Fracture Surgery
TLDR
RA may offer advantages over GA for fragility hip fracture surgeries when possible, and in-hospital mortality, time to death, increased LOS, and discharge to an institute rather than home were all adversely influenced by GA.
Effects of regional versus general anesthesia on outcomes after total hip arthroplasty: a retrospective propensity-matched cohort study.
TLDR
Compared with general anesthesia, regional anesthesia for total hip arthroplasty was associated with a reduction in deep surgical site infection rates, hospital length of stay, and rates of postoperative cardiovascular and pulmonary complications.
Comparison of regional with general anesthesia on mortality and perioperative length of stay in older patients after hip fracture surgery.
TLDR
It is demonstrated that the use of regional anesthesia was not associated with 30- or 90-day mortality, but it was associated with slightly shorter perioperative LOS, which has implications for more efficient healthcare resource utilization and quality assurance in geriatric care.
A Population-based Comparative Effectiveness Study of Peripheral Nerve Blocks for Hip Fracture Surgery.
TLDR
Receipt of nerve blocks for hip fracture surgery is associated with decreased length ofStay and health system costs, although small effect sizes may not reflect clinical significance for length of stay.
Hip Fracture Surgery: Does Type of Anesthesia Matter?
TLDR
Even though administration of regional anesthesia was positively correlated with shorter operative duration, the type of anesthesia was not found to affect surgical outcomes in the two study groups, and it is recommended that anesthesia should be tailored to individual patient requirements.
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