Fifty percent of home residents with a hip fracture die or are unable to walk by themselves after six months of suffering from the injury.
According to the new study, hip fracture surgery patients who took regional anesthesia also have a lower risk of death and shorter hospital stay compared to those who were given general anesthesia.
University of Pennsylvania researchers compared the anesthesia technique among 56,729 patients in New York aged over 50 who stayed in the hospital for a hip fracture diagnosis from 2004 to 2011. Among the patients, 28 percent or 15,904 were given regional anesthesia and 72 percent or 40,825 got general anesthesia during the surgery. The data were taken from New York's Planning and Research Cooperative System (SPARCS).
The team looked into the link of regional anesthesia (epidural or spinal) versus general anesthesia with 30-day mortality and length of stay in the hospital after the hip fracture surgery. The average hospital stay was six days for patients who received regional anesthesia and 6.3 days for those who got general anesthesia. In a related study, the team also found that hip fracture increases the risk of disability and death of nursing home residents.
Around 300,000 hip fracture cases happen in the United States every year. It is twice as common for nursing home residents than other seniors. Nursing home residents who cannot ambulate anymore have a restricted ability to participate in home activities. They will spend more time in bed which increases their frailty.
The team addressed the bias by employing a technique that simulated a randomized trial structure. Anesthesia patterns can differ in hospitals and the researchers used the distance from the patient's home address to the nearest clinic which specialized in regional anesthesia as the source of randomization to general versus regional anesthesia. According to the researchers, patients who had homes closer to clinics that specialized in regional anesthesia were more likely to get it and those who had homes closer to clinics that specialized in general anesthesia got it as well.
From this, the team estimated that regional anesthesia took a shorter length of stay of over half a day after hip fracture surgery than general anesthesia but no evidence for a significant difference in 30-day mortality based on anesthesia type was found.
