Comparative Retrospective Research Examining the Effects of Anesthetic Type on Post-Hip Bipolar Hemiarthroplasty Mortality and Morbidity Case Study

Abstract Background: In the literature there are few studies that compare the effect of the type of anesthesia on mortality and morbidity after hip surgery. For hip fracture operations, besides the general anesthesia (GA) and neuro-axial block (NB) techniques, recently, the combined lumbar plexus and sciatic nerve block (CLSB) technique is recommended, especially for high-risk patients. The purpose of this study is to establish a relationship between the type of anesthesia and mortality and morbidity of hip fracture surgery. Our hypothesis is that CLSB technique will decrease mortality and morbidity related to pulmonary and cardiovascular complications, thus reducing in-hospital stay of the patient and hospitalization cost. Methods: we retrospectively reviewed the charts of 375 patients, who underwent hip hemiarthroplasty from year 2000 till year 2014, 213 patients underwent the surgery under CLSB anesthesia, 114 patients under general anesthesia, and 48 patients under neuro-axial block. Patients or their relatives were contacted for data collection about postoperative quality of life changes. Results: one and five years survival rate was higher and possibility of perioperative complications was less after total hip hemiarthroplasty using CLSB anesthesia, time from trauma to operation was also a predictor for higher mortality. Patients who underwent operations under CLSB technique had better functional outcome at 3 month follow up. Conclusions: To decrease the mortality rate after hip fracture and improve functional outcomes, since age and ASA status are patient-dependent factors that cannot be changed, patients must be operated on as soon as possible. Because CLSB is an encouraging technique to operate patients earlier, we recommend CLSB technique in hip fracture patients, especially for patients with poor general health status.