In a study of more than 18,000 patients having surgery for hip fracture, researchers at the Perelman School of Medicine at the University of Pennsylvania found that the use of regional anesthesia, instead of general anesthesia, was associated with a significant reduction in major pulmonary complications and death. The new study will be published in the July issue of the journal Anesthesiology.
"Hip fracture is a common and costly event among older adults," said lead study author Mark D. Neuman, MD, assistant professor of Anesthesiology and Critical Care and senior fellow at the Leonard Davis Institute for Health Economics. "One out of five hip fracture patients dies within a year of their injury. There is an urgent need for better information to guide patients and clinicians in making decisions about anesthesia for hip fracture surgery, but so far very few large observational studies in the general population have examined this issue."
Hip fractures are a global public health problem, occurring 1.6 million times worldwide, and their incidence is anticipated to grow rapidly during the next three decades because of the aging of the population. Most hip fractures occur in people older than 65, with rates of morbidity and mortality increasing rapidly after age 80. A hip fracture almost always requires surgical treatment, followed by weeks to months of rehabilitation.
Dr. Neuman and his co-authors examined a retrospective cohort of patients undergoing surgery for hip fracture in 126 hospitals in New York in 2007 and 2008, which included a total of 18,158 patients. They compared rates of inpatient mortality, major pulmonary complications, and major cardiovascular complications among patients receiving regional anesthesia--including epidural, spinal or nerve block procedures--versus general anesthesia.
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