Impact of Anesthesia Type on Mortality and Postoperative Intensive Care Unit Admission in Geriatric Hip Fracture Surgery: A Retrospective Cohort Study

Abstract

Purpose: This retrospective cohort study primarily aims to assess the connection between the type of anesthesia used and in-hospital mortality among elderly patients with hip fractures. Additionally, it seeks to investigate mortality rates post-surgery, at 30 days, and at 1 year, categorized by the need for intensive care (ICU), age groups, and ASA classification.Materials and Methods: Researchers conducted a retrospective analysis of patients who had hip fracture surgery from January 2015 to February 2022, dividing them into three categories: those who received general anesthesia (Group G), those who underwent neuraxial anesthesia (Group N), and those who had a peripheral nerve block (Group P). They compared demographic data, ASA scores, ICU needs, length of hospital stay, in-hospital mortality, and mortality rates at 30 days and 1 year.Results: A total of 944 geriatric patients participated in the study (Group G: n=74; Group N: n=828; Group P: n=42). The demographic characteristics were similar across the groups; however, the ASA scores were notably higher in the peripheral nerve block group (p=0.002). There was a significant variation in ICU admission rates among the groups (p<0.001), with Group P having the highest rate at 59.5%, followed by Group G at 52.7%, and Group N at 34.1%. The duration of ICU and hospital stays was comparable. In-hospital mortality was elevated in the peripheral nerve block group (p=0.026), while no significant differences were found in mortality at 30 days or 1 year. Regardless of the anesthesia method, patients aged 80 years or older and those with higher ASA scores were linked to increased mortality.Conclusion: While the type of anesthesia seems linked to mortality rates and the need for ICU care in geriatric patients undergoing hip fracture surgery, factors related to the patient, such as older age and a higher ASA classification, might have a more significant impact. There were no notable differences in long-term mortality between the different anesthesia methods.