Document Type
Conference Proceeding
Publication Date
4-13-2024
Abstract
OBJECTIVE: Rates of complications with differing anesthetic choices has not been directly compared for patients undergoing total hip arthroplasty (THA) for femoral neck fractures. This study sought to directly compare neuraxial vs. general anesthetic use and compare postoperative outcomes for patients undergoing THA for a femoral neck fracture. METHODS: From 2012-2021, the National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing THA for a femoral neck fracture. Anesthetic type was identified and categorized as neuraxial (spinal, epidural) or general. Demographic and comorbid variables were collected. Days from admission to surgery was also identified. Postoperative complications were then compared between cohorts. RESULTS: 8,130 patients were included in analysis. 26% received neuraxial anesthesia. There was no difference in age, gender, or smoking status between cohorts. Patients receiving neuraxial anesthesia had a slightly lower BMI, less comorbidities, and were more likely to undergo surgery on the day of admission or the day after admission, but these differences were small. On univariate analysis, patients receiving neuraxial anesthesia had a lower risk of readmission (5.8 vs. 7.1%), discharge to a non-home destination (44.5 vs. 55.8%), an extended postoperative LOS (36.8 vs. 42.3%), or any postoperative medical complication (6.4% vs. 8.4%). On multivariate analysis, there was a 1.30 (p=.009) times increased odds of any medical complication, a 1.22 (p<0.001) times increased odds of an extended postoperative LOS, and a 1.60 (p<0.001) times increased odds of a non-home discharge destination for those receiving general vs. neuraxial anesthesia. There was no difference in readmission rates (1.19, p=0.100). CONCLUSION: This study finds that neuraxial anesthesia is associated with improved short-term outcomes compared to general anesthesia for patients receiving THA for a femoral neck fracture. The results of this study would suggest that in the appropriate patient, spinal anesthesia may be preferable to general anesthesia for THA done for femoral neck fractures.
Recommended Citation
Farley KX, Mouzaihem H, Dean RS, Karadsheh M, Cavinatto L, Wilson J, et al. [Moore D]. Neuraxial vs. general anesthesia in total hip arthroplasty for femoral neck fracture: a comparison of postoperative complications. Presented at: Mid-America Orthopaedic Association 41st Annual Meeting; 2024 Apr 13; Bonita Springs, FL. Available from:https://maoa.memberclicks.net/assets/Abstracts/MAOA%202024%20abstracts.pdf
Comments
Mid-America Orthopaedic Association 41st Annual Meeting, April 10-14, 2024, Bonita Springs, FL