Regional anesthesia as compared with general anesthesia for surgery in geriatric patients with hip fracture: does it decrease morbidity, mortality, and health care costs? results of a single-centered study
Pain Medicine, 07/17/2012
Le–Wendling L et al. – There is no difference in postoperative morbidity, rates of rehospitalization, in–patient mortality or hospitalization costs in geriatric patients undergoing regional or general anesthesia for repair of hip fracture. Delay in surgery beyond 3 days and ICU admission both increase cost of hospitalization.Methods
- This retrospective cohort study involved data collection from electronic and paper charts of 308 patients who underwent surgery for hip fracture from September 2006 to December 2008.
- Data on postoperative morbidity, in–patient mortality, and cost of hospitalization (as estimated from data on hospital charges) were collected and analyzed.
- Seventy–three patients received regional anesthesia and 235 patients received general anesthesia.
- During July 2007, approximately halfway through the study period, a regional anesthesia and analgesia program was introduced.
- The average cost of hospitalization in patients who received surgery for hip fracture was no different between patients who receive regional or general anesthesia ($16,789 + 631 vs $16,815 + 643, respectively, P = 0.9557).
- Delay in surgery and intensive care unit (ICU) admission resulted in significantly higher hospitalization costs.
- Age, male gender, African American race and ICU admission were associated with increased in–hospital mortality.
- In–hospital mortality and rates of readmission are not statistically different between the two anesthesia groups.