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Mortality Down With Spinal Anesthesia for Hip Fx Surgery

Increased incidence of pulmonary embolism and major blood loss with general anesthesia

FRIDAY, April 20, 2018 (HealthDay News) — For patients undergoing hip fracture fixation, general anesthesia (GA) is associated with increased 90-day mortality compared with spinal anesthesia (SA), according to a study presented at the 2018 World Congress on Regional Anesthesia and Pain Medicine, held from April 19 to 21 in New York City.

Sarah Tierney, M.D., from the University of Toronto, and colleagues conducted a retrospective study to examine the correlation of anesthetic technique and mortality in patients undergoing hip fracture fixation over a 13-year period. A total of 2,591 patients who underwent hip fracture fixation were identified; 883 of these in the SA group were matched to patients in the GA group. Clinical, laboratory, and outcome data were obtained, and mortality data were collected from the hospital discharge database.

The researchers found that patients receiving GA had increased 90-day mortality (8.6 versus 6.3 percent; P < 0.001); they also have elevated incidence of pulmonary embolism and major blood loss (2.3 versus 0.5 percent and 7.7 versus 4.8 percent, respectively; both P < 0.001). There was no between-group difference noted in hospital length of stay or major cardiac events.

“This observational propensity-score, matched-pairs, cohort study suggests a strong association between spinal anesthesia and lower 90-day mortality, as well as reduced rates of pulmonary embolism [and] major blood loss and a shorter hospital length of stay,” the authors write.

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