Is Anesthesia Technique Associated With a Higher Risk of Mortality or Complications Within 90 Days of Surgery for Geriatric Patients With Hip Fractures?

Desai, Vimal; Chan, Priscilla H.; Prentice, Heather A.; Zohman, Gary L.; Diekmann, Glenn; Maletis, Gregory B.; Fasig, Brian H.; Diaz, Diana Noemi; Chung, Elena; Qiu, Chunyuan

doi:10.1007/s11999.0000000000000147

Cited by 52 publications

(25 citation statements)

References 27 publications

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“…A registry-based study could investigate whether surgical approach, larger heads, dual mobility heads, modified soft-tissue repair [3], or implant fixation method (cemented or uncemented) [5] influences complication rates. Registries have been used to answer other similar questions regarding perioperative techniques and complication risk [1,6].…”

Section: Where Do We Need To Go?mentioning

confidence: 99%

CORR Insights®: Is Parkinson’s Disease Associated with Increased Mortality, Poorer Outcomes Scores, and Revision Risk After THA? Findings from the Swedish Hip Arthroplasty Register

Giori

2019

Clin Orthop Relat Res

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The author certifies that neither he, nor any members of his immediate family, have any commercial associations (such as consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR ® or The Association of Bone and Joint

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Section: Where Do We Need To Go?mentioning

confidence: 99%

CORR Insights®: Is Parkinson’s Disease Associated with Increased Mortality, Poorer Outcomes Scores, and Revision Risk After THA? Findings from the Swedish Hip Arthroplasty Register

Giori

2019

Clin Orthop Relat Res

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“…However, a recent retrospective study that included 16,695 geriatric patients and analyzed mortality within 90 days of undergoing hip fracture repair surgery showed that GA and conversion from RA to GA were associated with a higher risk of mortality (HR 1.22, 95% CI 1.11-1.35, P < 0.001) during hospital stay when compared with RA, but this higher risk did not persist after discharge. Furthermore, GA was associated with a higher risk of all-cause readmission when compared with RA, suggesting that RA may be preferable [79]. Another 2019 retrospective comparative study including 89 patients ≥ 70 years old undergoing major lumbar surgery showed that there was an association between epidural anesthesia and superior perioperative outcomes, such as episodes of hypertension and tachycardia during anesthesia and POD, nausea, vomiting, and pain [80].…”

Section: Mode Of Anesthesiamentioning

confidence: 99%

Anesthetic management of geriatric patients

Lim

2020

Korean J Anesthesiol

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The number of elderly patients who frequently access health care services is increasing worldwide. While anesthesiologists are developing the expertise to care for these elderly patients, areas of concern remain. We conducted a comprehensive search of major international databases (PubMed, Embase, and Cochrane) and a Korean database (KoreaMed) to review preoperative considerations, intraoperative management, and postoperative problems when anesthetizing elderly patients. Preoperative preparation of elderly patients included functional assessment to identify preexisting cognitive impairment or cardiopulmonary reserve, depression, frailty, nutrition, polypharmacy, and anticoagulation issues. Intraoperative management included anesthetic mode and pharmacology, monitoring, intravenous fluid or transfusion management, lung-protective ventilation, and prevention of hypothermia. Postoperative checklists included perioperative analgesia, postoperative delirium and cognitive dysfunction, and other complications. A higher level of perioperative care was required for older surgical patients, as multiple chronic diseases often makes them prone to developing postoperative complications, including functional decline and loss of independence. Although the guiding evidence remains poor so far, elderly patients have to be provided optimal perioperative care through close interdisciplinary, interprofessional, and cross-sectional collaboration to minimize unwanted postoperative outcomes. Furthermore, along with adequate anesthetic care, well-planned postoperative care should begin immediately after surgery and extend until discharge.

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“…The 42 studies described outcomes in 436 310 patients, of whom 70·9 per cent were men ( Table ), and 47·1 per cent of patients had an ASA grade of III or higher. The most common procedure studied was hip fracture (22 studies), followed by endovascular stroke therapy (7) and ankle fracture fixation (3).…”

Section: Demographicsmentioning

confidence: 99%

Scoping review of mode of anaesthesia in emergency surgery

Morley

Elliott

Rees

et al. 2020

British Journal of Surgery

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Background Emergency surgery encompasses more than 50 per cent of the surgical workload; however, research efforts are disproportionally low. The mode of anaesthesia used during emergency surgery may affect outcomes, but the extent of research and the impact of the different modes of anaesthesia used are unclear. Methods MEDLINE and Embase were searched using scoping review methodology with a rapid systematic search strategy, identifying any study comparing locoregional (local, nerve block, subarachnoid, epidural) anaesthesia with general anaesthesia. All studies describing outcomes of emergency surgery with differing modes of anaesthesia were identified. Excluded were: studies published before 2003, studies enrolling patients aged less than 18 years and studies using sedation only. Results Forty‐two studies were identified, describing 11 surgical procedures. Most publications were retrospective cohort studies (32). A very broad range of clinical and patient‐reported outcomes were described, with wide variation in the outcomes reported in different studies. Conclusion Reporting of mode of anaesthesia is inconsistent across different procedures and is often absent. There is a need for directed research efforts to improve the reporting standards of anaesthesia interventions, to understand the role of different modes of anaesthesia in specific emergency surgical procedures, and to standardize outcome reporting using core outcome sets.

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Is Anesthesia Technique Associated With a Higher Risk of Mortality or Complications Within 90 Days of Surgery for Geriatric Patients With Hip Fractures?

Abstract: Level III, therapeutic study.

Cited by 52 publications

References 27 publications

CORR Insights®: Is Parkinson’s Disease Associated with Increased Mortality, Poorer Outcomes Scores, and Revision Risk After THA? Findings from the Swedish Hip Arthroplasty Register

CORR Insights®: Is Parkinson’s Disease Associated with Increased Mortality, Poorer Outcomes Scores, and Revision Risk After THA? Findings from the Swedish Hip Arthroplasty Register

Anesthetic management of geriatric patients

Scoping review of mode of anaesthesia in emergency surgery

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