Drugs Xagena
A retrospective cohort study has evaluated the effect of anesthesia type on the risk of in-hospital mortality among adults undergoing hip fracture surgery in the United States.
Participants were 73 284 adults undergoing hip fracture surgery on hospital day 2 or greater between 2007 and 2011. Of those, 61 554 ( 84.0% ) received general anesthesia, 6939 ( 9.5% ) regional anesthesia, and 4791 ( 6.5% ) combined general and regional anesthesia.
The main outcome measure was in-hospital all cause mortality.
In-hospital deaths occurred in 1362 ( 2.2% ) patients receiving general anesthesia, 144 ( 2.1% ) receiving regional anesthesia, and 115 ( 2.4% ) receiving combined anesthesia.
In the multivariable adjusted analysis, when compared with general anesthesia the mortality risk did not differ significantly between regional anesthesia ( risk ratio, RR=0.93 ) or combined anesthesia ( 1.00 ).
A mixed effects analysis accounting for differences between hospitals produced similar results: compared with general anesthesia the risk from regional anesthesia was 0.91 and from combined anesthesia was 0.98.
Findings were also consistent in subgroup analyses.
In this large nationwide sample of hospital admissions, mortality risk did not differ significantly by anesthesia type among patients undergoing hip fracture surgery.
The results suggest that if the previously posited beneficial effect of regional anesthesia on short term mortality exists, it is likely to be more modest than previously reported. ( Xagena )
Patorno E et al, BMJ 2014;348:g4022
XagenaMedicine_2014
