%0 Journal Article
%T Hip Fracture Mortality: Is It Affected by Anesthesia Techniques?
%A Saffet Karaca
%A Egemen Ayhan
%A Hayrettin Kesmezacar
%A Omer Uysal
%J Anesthesiology Research and Practice
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/708754
%X We hypothesized that combined peripheral nerve block (CPNB) technique might reduce mortality in hip fracture patients with the advantage of preserved cardiovascular stability. We retrospectively analyzed 257 hip fracture patients for mortality rates and affecting factors according to general anesthesia (GA), neuraxial block (NB), and CPNB techniques. Patients¡¯ gender, age at admission, trauma date, ASA status, delay in surgery, followup period, and Barthel Activities of Daily Living Index were determined. There were no differences between three anesthesia groups regarding to sex, followup, delay in surgery, and Barthel score. NB patients was significantly younger and CPNB patients¡¯ ASA status were significantly worse than other groups. Mortality was lower for regional group (NB + CPNB) than GA group. Mortality was increased with age, delay in surgery, and ASA and decreased with CPNB choice; however, it was not correlated with NB choice. Since the patients¡¯ age and ASA status cannot be changed, they must be operated immediately. We recommend CPNB technique in high-risk patients to operate them earlier. 1. Introduction ¡°Hip fracture¡± refers to a fracture of the femur in the area of bone immediately distal to the articular cartilage of the hip, to a level of about five centimeters below the lower border of the lesser trochanter [1]. Hip fracture prevalence is rising with the continued ageing of the population [2]. Studies have demonstrated the increased risk of mortality after hip fracture especially during the first year, and excess mortality risk may persist for several years after fracture [3¨C5]. 23.8% of patients die in the first year after hip fracture and one in three patients require a higher level of long-term care [3]. For hip fracture operations, besides the general anesthesia (GA) and neuraxial block (NB) techniques, recently, the combined lumbar plexus and sciatic nerve block (CLSB) technique is recommended, especially for high-risk patients [6¨C10]. When compared with GA and NB, minimal hemodynamic disturbance and so less affected cardiovascular stability are the advantages of CLSB [6¨C11]. NB is argued to reduce mortality when compared with GA [1, 12, 13]; however, survival studies in hip fracture patients have not analyzed the effects of CLSB on mortality. In our recently published research about mortality after hip fracture [14], there was an uncertain relationship between mortality and anesthesia type. In order to face the relationship out, we purposed to determine mortality of patients after hip fracture according to anesthesia type.
%U http://www.hindawi.com/journals/arp/2012/708754/