The Effects of Anesthesia Type on the Prognosis of Hip Fracture Surgery on Elderly Patients

Hip fracture is a common disease among elderly people,and has a high mortality and morbidity.But,seldom practice can be done to improve this condition.For a long time,whether anesthesia type could influence the prognosis after surgery is controversial.Several studies have confirmed regional anesthesia may be better for patients for its fewer complications.But most studies are retrospective,and information may be less convincing .Besides,as a matter of fact,patients of different anesthesia type may have different status,so,a scoring system may be need for comparing the status of patients of different groups.

Our study is a prospective observational trial.Patients needing hip fracture surgery are divided into two groups according to the anesthesia type during surgery:Regional Anesthesia group(RA),General Anesthesia group(GA).To evaluate the status of patients before surgery,we use Orthopedic POSSUM scoring system.It consists of 12 physiological factors and 6 operative severity factors.Then,we will observe outcome of the two groups and record every complication after surgery.Finally,the initial and adjusted morbidity and mortality according to Orthopedic POSSUM scoring system of the two groups are compared.

• Anesthesia type (Procedure): RA group uses regional anesthesia(epidural, spinal, combined spinal and epidural anesthesia or nerve block) ,and GA group uses general anesthesia(general anesthesia combined with peripheral nerve blockade, general anesthesia combined with spinal/epidural anesthesia or single general anesthesia) .

Primary outcomes

• Mortality [30-day after surgery]

Secondary outcomes

• Morbidity [30-day after surgery]
• VAS pain score [everyday after surgery,record for 7 days]

Other outcomes

• The Orthopedic POSSUM score [baseline]

Sex: All, ages: 60 Years to any

Inclusion Criteria:

* Patients with hip fracture;
* Need surgery;
* Anesthesia type is regional anesthesia or general anesthesia;
* Age≥60 years.

Exclusion Criteria:

* Choosing conservative treatment;
* Other types of anesthesia or without anesthesia.

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• Ting Li, M.D., Study chair, The Second Affiliated Hospital & Yuying Children hospital of Wenzhou Medical University
• Yahe Ge, Medical Student, Principal investigator, The Second Affiliated Hospital & Yuying Children hospital of Wenzhou Medical University