Purpose: This study compared postoperative morbidity and mortality in elderly patients who received either general or spinal anesthesia for hip fracture repair.
Methods: We retrospectively analyzed the hospital records of 335 elderly patients (> 80 years old) who received hip fracture repair in our hospital between 2002 and 2006. A total of 167 and 168 patients received general and spinal anesthesia, respectively. Morbidity, mortality, and intraoperative and preoperative variables were compared between groups.
Results: There were no mortality differences between spinal and general anesthesia groups. However, surgery duration and blood loss during surgery were significantly greater in general anesthesia patients, which may have contributed to the greater overall morbidity in the general anesthesia group (n = 21 [12.6%] general vs n = 9 [5.4%] spinal, P = 0.02). Respiratory-system–related morbidity was also higher in the general anesthesia group (n = 11 [6.6%] general vs n = 3 [1.8%] spinal). Logistic regression analysis revealed two significant predictors of postoperative morbidity: anesthesia type (general, odds ratio 2.39) and pre-existing respiratory diseases (odds ratio 3.38).
Conclusions: General anesthesia increased the occurrence of postoperative morbidity in elderly patients after hip fracture repair, and patients with preexisting respiratory diseases were especially vulnerable. Therefore, spinal anesthesia may be a better option in such individuals.
Key words: hip fracture, general anesthesia, spinal anesthesia, elderly, morbidity, mortality.
