Clinical Characteristics of Spinal versus General Anaesthesia in Older Patients Undergoing Hip Fracture Repair Surgery in Jordan: A Multicentre Study.

Autor:	Al-Husinat L; Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan., Al Sharie S; Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan., Araydah M; Department of Internal Medicine, Istishari Hospital, Amman 11942, Jordan., Al Modanat Z; Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan., Ismail MIA; Anesthesiology Department, Mut'ah School of Medicine, Al-Karak 61710, Jordan., Heilat HB; Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan., Dawod MS; Department of Special Surgery, College of Medicine, Mutah University, Al-Karak 61710, Jordan., Sawaftah KA; Department of General Surgery, Jordan Hospital, Amman 11152, Jordan., De Rosa S; Centre for Medical Sciences-CISMed, University of Trento, 38122 Trento, Italy.; Anesthesia and Intensive Care, Santa Chiara Regional Hospital, APSS, 38122 Trento, Italy., Battaglini D; Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
Jazyk:	angličtina
Zdroj:	Journal of personalized medicine [J Pers Med] 2023 Nov 16; Vol. 13 (11). Date of Electronic Publication: 2023 Nov 16.
DOI:	10.3390/jpm13111611
Abstrakt:	Background: The primary aim of this study was to examine the clinical characteristics and outcomes of older patients who underwent hip fracture repair surgery. The secondary aims were to assess the predictors of the choice of spinal or general anaesthesia and to explore the risk factors for all-cause mortality. Methods: This three-tertiary centres study was conducted at a tertiary care centre in Jordan. Clinical data include previous fracture history; medication details; comorbidities; surgical approach; and postoperative pain management. Results: Overall, 1084 patients who underwent hip fracture repair were included in this study. The mean age of patients was 78 years, and 55.2% were women. Twenty-four were treated with bisphosphonates before the fracture, whereas 30 were in steroid therapy. Overall, 61.8% of patients underwent spinal anaesthesia, whereas 38.2% underwent general anaesthesia. Spinal anaesthesia group had a lower prevalence of cardiovascular accidents (16.3% vs. 22.3%, p = 0.014) and Alzheimer's (3.4% vs. 1.4%, p = 0.049) than the general anaesthesia group. In the spinal anaesthesia group, postoperative opioid administration ( p = 0.025) and postoperative blood transfusion ( p = 0.011) occurred more frequently than general anaesthesia group. In hospital, 30-day and all-cause mortality were comparable between both groups. Diabetes mellitus (HR = 2.6; 95%CI = 1.5-4.4; p = 0.001); cemented hip hemiarthroplasty (HR = 2.4; 95%CI = 1.1-5.1; p = 0.025); deep venous thrombosis/pulmonary embolism (HR = 5.0; 95%CI = 1.2-12.9; p = 0.001); and readmission within 1 month from surgery (HR = 3.6; 95%CI = 2.0-6.3; p < 0.001) were all significant predictors of mortality. Conclusions: This study provides insights into the outcomes and factors associated with different anaesthesia types in hip fracture repair surgery. The anaesthesia type does not affect all-cause mortality in patients undergoing hip fracture repair.
Databáze:	MEDLINE
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