Anesthesia Technique, Mortality, and Length of Stay After Hip Fracture Surgery

Mark D. Neuman, MD, MSc; Paul R. Rosenbaum, PhD; Justin M. Ludwig, MA; Jose R. Zubizarreta, PhD; Jeffrey H. Silber, MD, PhD

JAMA. 2014;311(24):2508-2517

The investigators conducted a matched retrospective cohort study involving patients 50 years or older who were undergoing surgery for hip fracture at general acute care hospitals Of 56 729 patients, 15 904 (28%) received regional anesthesia and 40 825 (72%) received general anesthesia. Overall, 3032 patients (5.3%) died in New York State between July 1, 2004, and December 31, 2011.

To go beyond prior observational studies, they used 2 statistical techniques intended to address selection bias, multivariable matching, and instrumental variable analysis. They hypothesized that regional anesthesia would be associated with improved outcomes compared with general anesthesia.

The near-far matched analysis showed no significant difference in 30-day mortality by anesthesia type among the 21 514 patients included in this match

Regional anesthesia was associated with a 0.6-day shorter length of stay than general anesthesia