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| Authors | J Gonzi M Zammit |
| Abstract | Introduction: Several factors have been associated with increased morbidity and mortality after surgery for hip fractures. Age, co-existing medical illnesses, the timing of surgery after trauma, the type of anaesthesia and the period of post-surgical immobilization are all factors which are known to play a role in the outcome. Aim: The aim of this retrospective and consecutive study was to assess the impact of the anesthetic technique on the various aspects of the surgical outcome. Method: After obtaining ethical approval, 123 patients files from a total of 209 emergency admissions between June and December 2003 for hip fracture surgery, were traced from the records department. The type of anaesthesia used, either general or regional anaesthesia alone or in combination, common complications, mortality and length of hospital stay were recorded. Results: 75% of hip surgery performed at St Lukes Hospital Malta, were emergency procedures. 52% were dynamic hip screw insertions. Average age was 72 years, 38.21% of patients were between 80-89 years of age. 47% of patients received general anaesthesia while 50% received regional block. The 30 day mortality after surgery was 13.8% after general anaesthesia and 8% after regional anaesthesia. The one year mortality was 29.3% after general anaesthesia and 14.7% after regional anaesthesia. There was no difference in the duration of hospital stay between patients receiving regional or general anaesthesia (14.3 days versus 13.04 days). Conclusion: Regional anaesthesia reduces postoperative mortality and morbidity, but since the etiology is often multifactorial in nature, using unimodal interventions such as regional anaesthesia will not necessarily decrease mortality. |
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| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | anaesthesia, audit, morbidity, mortality, technique, surgical outcomes |