The Impact of Timing of Surgery and the Anesthesia Technique in Hip Fracture Surgery on In-hospital Mortality and Length of Hospital Stay
Journal Title: Journal of Academic Research in Medicine - Year 2020, Vol 10, Issue 1
Abstract
Objective: To point the positive impact of early surgery (performed within 48 hours) and non-general anesthesia techniques on early outcomes like in-hospital mortality and length of hospital stay (LOS). Methods: Seven hundred and ten patients were included in this retrospective study. Patients aged 50 years and over, who were admitted to our hospital with hip fracture, were included, while the patients with pathological fractures or polytraumatic injuries were excluded. Results: The median age of the patients was 75.8±10,.3 years. Four hundred and sixty-nine (66.1%) patients were female. Six hundred and eighty-two patients (96.1%) were treated surgically, 16 patients (2.25%) received conservative treatment and 12 patients (1.7%) died before scheduled surgery. General anesthesia (n=328), spinal anesthesia (n=268), unilateral spinal anesthesia (n=47), peripheral nerve block (n=29), and combined spinal-epidural (CSE) anesthesia (n=10) were the anesthesia techniques used for surgery. Patients who were treated within 48 hours (G1) had lower in-hospital mortality than the patients who were treated lately (G2) (0.8% vs 4,7%). The LOS for G1 was 8.6 days whereas it was 17.5 days for G2 (p<0.001). Mortality rates and median LOS of the anesthesia techniques were 5.5% and 15 days with general anesthesia, 2.2% and 14 days with spinal, and 4.3% and 13 days with unilateral spinal anesthesia. There were no deaths in 10 patients with 11.5 days of LOS, who received CSE anesthesia, while the mortality rate of the peripheral nerve block group was 3.4% with 10 days of LOS. Conclusion: The results of this study suggest that the surgical repair of the fractured hip should be performed within the first 48 hours, with a non-general anesthesia technique in order to reduce in-hospital mortality and LOS.
Authors and Affiliations
Gülay Kır, Mehmet Buget, Kemalettin Koltka, Mustafa Çağlar Kir, Kamil Pembeci
Keywords
Related Articles
- EP ID EP684381
- DOI 10.4274/jarem.galenos.2019.2076
- Views 207
- Downloads 0
Angiolipoma-like Atypical Lipomatous Tumor/Welldifferentiated Liposarcoma
Lipomas are benign mesenchymal neoplasms. Angiolipoma is a variant of ordinary lipomas, characterized by adipocytic cells as well as capillary vascular clusters. Atypical lipomatous tumors are local aggressive mesenchyma...
Supero-inferior Thyroidectomy Technique in Papillary Thyroid Carcinoma: Preliminary Results of Thirteen Cases with Intraoperative Nerve Monitoring
Objective: This study aimed to investigate the novel use of a surgical technique using intraoperative nerve monitoring (IONM) technology in conjunction with supero-inferior thyroid dissection technique for selected cases...
Radioguided Occult Lesion Localization Versus Wire-guided Localization of Nonpalpable Breast Lesions: A Comparative Analysis
Objective: Wire-guided localization (WGL) is the preoperative localization method most commonly used before the surgical excision of non-palpable breast lesions (NPBLs). Recently, radioguided occult lesion localization (...
Cervical Lipoleiomyoma: Case Report
Lipoleiomyomas are uncommon benign neoplasms composed of various mixtures of long intersecting bundles of bland smooth-muscle cells and mature adipocytes. These tumors are most commonly located in the uterine corpus, but...
Anesthetic Approach for a Patient with 1q21.1 Microdeletion Syndrome: A Case Report
1q21.1 microdeletion syndrome is a chromosome abnormality where segment of genetic material on the long (q) arm of chromosome 1 at position 21.1 is missing or deleted. Distal 1q21.1 microdeletion is associated with micro...