Research Article
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Evaluation of Geriatric Patients Undergoing Hip Surgery: A Retrospective Study

Year 2020, Volume: 6 Issue: 3, 397 - 403, 31.12.2020
https://doi.org/10.19127/mbsjohs.754984

Abstract

Objective: Global improvement in the quality of life has led to a rapid expansion of the elderly population. A majority of patients undergoing hip or lower extremity surgery belong to the geriatric age group; in these patients, regional anaesthesia is generally preferred over general anaesthesia due to the common occurrence of concomitant conditions. In this study, we investigated the effect of the anaesthetic technique on mortality, morbidity, and clinical outcomes in geriatric patients undergoing hip surgery.
Methods: This study evaluated 700 patients over 65 years of age with an ASA status of III/IV who had undergone hip surgery between 2009 and 2013 at Firat University Hospital. Based on a review of patient records, 114 patients were eligible for the study. The two groups were comparable in terms of age, ASA status,gender, anaesthesia duration, haemoglobin levels at baseline and discharge, complication rates, need for post-operative intensive care unit admission, concomitant conditions, need for volume replacement, mortality rate and need for blood and blood products.
Results: Patients were divided into the general (n = 76) and regional (n = 38) anaesthesia groups. Pre- and post-operative haemoglobin levels were not significantly different between the two groups(p>0.068) Surgery duration (113.68 ± 34.73 min) and hospital stay length (11.42 ± 4.03 days) were statistically shorter in the regional anaesthesia group.
Conclusion: In geriatric patients undergoing hip surgery, regional anaesthesia is superior to general anaesthesia, as it results in reduced surgery duration, hospital stay length and need for blood transfusions.

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References

  • Aldwinckle RJ, Montgomery JE. Unplanned admission rates and postdischarge complications in patients over the age of 70 following day case surgery. Anaesthesia; 2004;59(1),57-9.
  • Bettelli G. Anaesthesia for the elderly outpatient: preoperative assessment and evaluation, anaesthetic technique and postoperative pain management. Curr Opin Anaesthesiol; 2010;23(6),726-31.
  • Chen Dong Xu, Yang Lei, Ding Lin, Li Shi Yue , Qi Ya Na, Li Qian. Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques: A systematic review and meta-analysis Medicine (Baltimore); 2019 Dec; 98(49), e18220. Published online 2019 Dec 10. doi: 10.1097/MD.0000000000018220
  • Chung F, Mezei G, Tong D. Adverse events in ambulatory surgery. A comparison between elderly and younger patients. Can J Anaesth;1999; 46(4), 309-321.
  • Celik F, Tufek A, Yildirim ZB, Karaman H, Baykan H, Olmez Kavak G et al. Spinal anesthesia with small dose bupivakain in the highly elderly patient J Clin Exp Invest; 2010;1(3),214-15.
  • Deiner S, Silverstein JH. Anesthesia for geriatric patients. Minerva Anestesiol;2011;77(2),180-9
  • Franzo A, Francescutti C, Simon G. Risk factors correlated with post-operative mortality for hip fracture surgery in the elderly: a population-based approach. Eur J Epidemiol; 2005;20(12), 985-91.
  • Foss NB, Kehlet H. Mortality analysis in hip fracture patients: implications for design of future outcome trials. Br J Anaesth; 2005; 94(1), 24-9.
  • Jin F, Chung F. Minimizing perioperative adverse events in the elderly. Br J Anaesth; 2001; 87(4),608-24.
  • Liu Y, Xiao W, Meng LZ, Wang TL. Geriatric Anesthesia-related Morbidity and Mortality in China: Current Status and Trend. Chin Med J; 2017;130(22),2738-49.
  • Maurer SG, Chen AL, Hiebert R, Pereira GC, Di Cesare PE. Comparison of outcomes of using spinal versus general anesthesia in total hip arthroplasty. Am J Orthop; 2007; 36(7),E101-E106.
  • McKenzie PJ, Wishart HY, Smith G. Long-term outcome after repair of fractured neck of femur. Comparison of subarachnoid and general anaesthesia. Br J Anaesth; 1984;56(6),581-5.
  • Melendez HJ, Mercado A, Cobos JH. Morbimortality in major hip surgery: A study of the efficacy of selective subarachnoideal spinal anaesthesia compared to balanced general anaesthesia. A controlled clinical trial. Rev Col Anest;2009;37(3),189-201
  • Meyer HE, Tverdal A, Falch JA, Pedersen JI. Factors associated with mortality after hip fracture. Osteoporos Int; 2000;11,228-32 doi.org/10.1007/s001980050285
  • Neuman MD, Rosenbaum PR, Ludwig JM, Zubizarreta JR, Silber JH. Anesthesia technique, mortality, and length of stay after hip fracture surgery. JAMA; 2014;311(24),2508-17
  • Ogurlu M, Sen S, Ugur B, Discigil G, Aydın ON, Gursoy F. Evaluation of Hypotension Development Due to Spinal Anesthesia in Patients Over 65 Years of Age Turkish Journal of Geriatrics; 2007; 9(3),126-9.
  • Patel V, Champaneria R, Dretzke J, Yeung J . Effect of regional versus general anaesthesia on postoperative delirium in elderly patients undergoing surgery for hip fracture: a systematic review BMJ Open;.2018; 8(12),e020757. doi: 10.1136/bmjopen-2017-020757
  • Polanczyk CA, Marcantonio E, Goldman L, et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med; 2001; 134(8), 637-43.
  • Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ;2000;321(7275),1493-7.
  • Seyedi HR, Mahdian M, Khosravi G, Bidgoli MS, Mousavi SG, Razavizadeh MR, et al. Prediction of mortality in hip fracture patients:role of routine blood tests. Archives of bone and joint surgery; 2015;3(1),51-55.
  • Strom C,Rasmussen LS,Sieber FE Should general anaesthesia be avoided in the elderly? Anaesthesia; 2014 Jan; 69(Suppl 1), 35–44.
  • Svensson O, Stromberg L, Ohlen G, Lindgren U. Prediction of the outcome after hip fracture in elderly patients. J Bone Joint Surg Br; 1996; 78,115-8.
  • Takmaz SA. Anesthesia in Orthopedic Surgery In: Kegik H, Alkış H, Yorükoglu D, Alanoglu Z (eds). Basic Anesthesia 1st edition, Gunes Medical Bookstores; Ankara 2012, pp 653-84
  • Turkmen A, Turgut N. Geriatric Anesthesia. Turkish Journal of Geriatrics 2007; 10(1), 49-56.
Year 2020, Volume: 6 Issue: 3, 397 - 403, 31.12.2020
https://doi.org/10.19127/mbsjohs.754984

Abstract

Project Number

yok

References

  • Aldwinckle RJ, Montgomery JE. Unplanned admission rates and postdischarge complications in patients over the age of 70 following day case surgery. Anaesthesia; 2004;59(1),57-9.
  • Bettelli G. Anaesthesia for the elderly outpatient: preoperative assessment and evaluation, anaesthetic technique and postoperative pain management. Curr Opin Anaesthesiol; 2010;23(6),726-31.
  • Chen Dong Xu, Yang Lei, Ding Lin, Li Shi Yue , Qi Ya Na, Li Qian. Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques: A systematic review and meta-analysis Medicine (Baltimore); 2019 Dec; 98(49), e18220. Published online 2019 Dec 10. doi: 10.1097/MD.0000000000018220
  • Chung F, Mezei G, Tong D. Adverse events in ambulatory surgery. A comparison between elderly and younger patients. Can J Anaesth;1999; 46(4), 309-321.
  • Celik F, Tufek A, Yildirim ZB, Karaman H, Baykan H, Olmez Kavak G et al. Spinal anesthesia with small dose bupivakain in the highly elderly patient J Clin Exp Invest; 2010;1(3),214-15.
  • Deiner S, Silverstein JH. Anesthesia for geriatric patients. Minerva Anestesiol;2011;77(2),180-9
  • Franzo A, Francescutti C, Simon G. Risk factors correlated with post-operative mortality for hip fracture surgery in the elderly: a population-based approach. Eur J Epidemiol; 2005;20(12), 985-91.
  • Foss NB, Kehlet H. Mortality analysis in hip fracture patients: implications for design of future outcome trials. Br J Anaesth; 2005; 94(1), 24-9.
  • Jin F, Chung F. Minimizing perioperative adverse events in the elderly. Br J Anaesth; 2001; 87(4),608-24.
  • Liu Y, Xiao W, Meng LZ, Wang TL. Geriatric Anesthesia-related Morbidity and Mortality in China: Current Status and Trend. Chin Med J; 2017;130(22),2738-49.
  • Maurer SG, Chen AL, Hiebert R, Pereira GC, Di Cesare PE. Comparison of outcomes of using spinal versus general anesthesia in total hip arthroplasty. Am J Orthop; 2007; 36(7),E101-E106.
  • McKenzie PJ, Wishart HY, Smith G. Long-term outcome after repair of fractured neck of femur. Comparison of subarachnoid and general anaesthesia. Br J Anaesth; 1984;56(6),581-5.
  • Melendez HJ, Mercado A, Cobos JH. Morbimortality in major hip surgery: A study of the efficacy of selective subarachnoideal spinal anaesthesia compared to balanced general anaesthesia. A controlled clinical trial. Rev Col Anest;2009;37(3),189-201
  • Meyer HE, Tverdal A, Falch JA, Pedersen JI. Factors associated with mortality after hip fracture. Osteoporos Int; 2000;11,228-32 doi.org/10.1007/s001980050285
  • Neuman MD, Rosenbaum PR, Ludwig JM, Zubizarreta JR, Silber JH. Anesthesia technique, mortality, and length of stay after hip fracture surgery. JAMA; 2014;311(24),2508-17
  • Ogurlu M, Sen S, Ugur B, Discigil G, Aydın ON, Gursoy F. Evaluation of Hypotension Development Due to Spinal Anesthesia in Patients Over 65 Years of Age Turkish Journal of Geriatrics; 2007; 9(3),126-9.
  • Patel V, Champaneria R, Dretzke J, Yeung J . Effect of regional versus general anaesthesia on postoperative delirium in elderly patients undergoing surgery for hip fracture: a systematic review BMJ Open;.2018; 8(12),e020757. doi: 10.1136/bmjopen-2017-020757
  • Polanczyk CA, Marcantonio E, Goldman L, et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med; 2001; 134(8), 637-43.
  • Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ;2000;321(7275),1493-7.
  • Seyedi HR, Mahdian M, Khosravi G, Bidgoli MS, Mousavi SG, Razavizadeh MR, et al. Prediction of mortality in hip fracture patients:role of routine blood tests. Archives of bone and joint surgery; 2015;3(1),51-55.
  • Strom C,Rasmussen LS,Sieber FE Should general anaesthesia be avoided in the elderly? Anaesthesia; 2014 Jan; 69(Suppl 1), 35–44.
  • Svensson O, Stromberg L, Ohlen G, Lindgren U. Prediction of the outcome after hip fracture in elderly patients. J Bone Joint Surg Br; 1996; 78,115-8.
  • Takmaz SA. Anesthesia in Orthopedic Surgery In: Kegik H, Alkış H, Yorükoglu D, Alanoglu Z (eds). Basic Anesthesia 1st edition, Gunes Medical Bookstores; Ankara 2012, pp 653-84
  • Turkmen A, Turgut N. Geriatric Anesthesia. Turkish Journal of Geriatrics 2007; 10(1), 49-56.
There are 24 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research articles
Authors

Tuba Çatak 0000-0001-8370-0739

Omer Erhan This is me 0000-0002-5991-0231

Ayşe Belin Özer 0000-0002-9979-9232

Mikail Kılınç This is me 0000-0002-6565-4991

Project Number yok
Publication Date December 31, 2020
Published in Issue Year 2020 Volume: 6 Issue: 3

Cite

Vancouver Çatak T, Erhan O, Özer AB, Kılınç M. Evaluation of Geriatric Patients Undergoing Hip Surgery: A Retrospective Study. Mid Blac Sea J Health Sci. 2020;6(3):397-403.

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