Prospective, multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly.

Abstract:

:In a prospective randomized multi-centre study, the mortality following internal fixation surgery for fracture of the upper femur was investigated in 538 elderly patients allocated to receive subarachnoid blockade or general (narcotic-relaxant) anaesthesia. The 28-day mortality was 6.6% with subarachnoid, and 5.9% with general, anaesthesia. The difference was not significant (95% confidence limits: -3.5 to +4.8). At 1 year following surgery, the mortality was 20.4%. Increasing age, ischaemic heart disease, cardiac failure, preoperative arrhythmias and poor ASA status were all associated with increases in early and long term mortality. A delay to surgery of more than 24 h from admission was also associated with an increased 28-day mortality. Senile dementia and admission other than from the patient's own home, were factors associated with a poorer long term outcome. From the point of view of mortality, subarachnoid anaesthesia did not appear to confer any advantages over general anaesthesia in non-prosthetic surgery for hip fracture in the elderly.

journal_name

Br J Anaesth

authors

Davis FM,Woolner DF,Frampton C,Wilkinson A,Grant A,Harrison RT,Roberts MT,Thadaka R

doi

10.1093/bja/59.9.1080

subject

Has Abstract

pub_date

1987-09-01 00:00:00

pages

1080-8

issue

9

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)38983-3

journal_volume

59

pub_type

临床试验,杂志文章,随机对照试验
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