DOCUMENTS

papers

Postoperative medical complications associated with anesthesia in older adults with dementia

Published: November 1, 2014
Category: Papers
Authors: Anderson GM, Austin PC, Bell CM, Gill SS, Gruneir A, Rochon PA, Seitz DP
Country: Canada
Language: null
Type: Population Health
Settings: Hospital, PCP

J Am Geriatr Soc 62:2102-2109.

Queen’s University, Kingston, On, Canada

OBJECTIVES: To examine the association between anesthetic technique and postoperative complications in older adults with dementia undergoing hip fracture surgery.

DESIGN: Population-based, retrospective cohort study.

SETTING: Ontario, Canada.

PARTICIPANTS: All older adults with dementia who underwent surgery for hip fracture repair in Ontario, Canada, between April 1, 2003 and March 31, 2011.

MEASUREMENTS: The baseline characteristics of individuals who received general anesthesia (GA) and regional anesthesia (RA) were compared. Individuals who received GA were matched to similar individuals who received RA using propensity scores to control for confounding, and their outcomes compared, including 30-day mortality, intensive care unit (ICU) admissions, specific postoperative medical complications, and hospital length of stay (LOS).

RESULTS: In the 6,135 matched pairs, there was no statistically significant difference in postoperative 30-day mortality (GA, 11.3%; RA, 10.8%, P = .44). There were no statistically significant differences in the rates of specific postoperative medical complications or LOS in the two anesthetic groups, but GA was associated with higher rates of ICU admissions (6.1% vs 4.2%, P < .001).

CONCLUSION: For older adults with dementia undergoing hip fracture surgery, GA and RA are associated with similar rates of most perioperative adverse events. Further studies are required to determine the optimal methods of providing anesthesia and perioperative care for older adults with dementia undergoing surgical procedures.

PMID: 25370019

Canada,Age,Co-morbidity,Outcome Measures,Practice Pattern Comparison,Aged,80 and over,Alzheimer Disease/mortality,Cohort Studies,Co-morbidity,Hip Fractures/mortality,Intensive Care Units/statistics & numerical data,Length of Stay/statistics & numerical data,Long-Term Care/statistics & numerical data,Matched-Pair Analysis,Ontario,Patient Admission/statistics & numerical data,Postoperative Complications/mortality,Propensity Score,Survival Analysis

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