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比较全身麻醉和局部麻醉对老年髋部骨折患者死亡率和住院时间的影响。

Comparison of the effects of general and regional anesthesia on mortality and hospital length of stay in geriatric hip fractures.

机构信息

Department of Anesthesiology and Reanimation, Dr. Ali Kemal Belviranlı Maternity and Children's Hospital, Konya, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Oct;27(20):9660-9667. doi: 10.26355/eurrev_202310_34137.

Abstract

OBJECTIVE

In this study, we sought to compare the effects of general and regional anesthesia techniques on the length of hospital stay and morbidity-mortality in geriatric patients who have had hip fractures and underwent surgical treatment.

PATIENTS AND METHODS

A total of 331 patients who were 65 or older and had had surgical treatment for elective or urgent hip fractures were classified into two groups; regional and general anesthesia. Recorded variables were: age, sex, American Society of Anesthesiologists (ASA) score, comorbid disease, length of stay at the clinic, mortality, morbidity, intraoperative loss of blood, the necessity of blood transfusion, and type of fracture. These variables were compared in the control groups and evaluated retrospectively.

RESULTS

For the regional anesthesia group, length of stay in the clinic, loss of blood, and necessity of blood transfusion were significantly lower compared to the general anesthesia group (p<0.05). Additionally, we found general anesthesia mortality and morbidity rates were significantly higher than regional anesthesia (p<0.05). Finally, we determined that increased age and number of comorbid diseases increased the morbidity and mortality rates significantly (p<0.05).

CONCLUSIONS

This study evaluated regional anesthesia's advantages over general anesthesia when treating geriatric hip fractures. This includes reduced morbidity-mortality rates, bleeding, and shorter length of hospital stay.

摘要

目的

本研究旨在比较全身麻醉和区域麻醉技术对接受择期或紧急髋关节骨折手术治疗的老年患者的住院时间和发病率-死亡率的影响。

患者和方法

将 331 名年龄在 65 岁及以上且接受过髋关节骨折择期或紧急手术治疗的患者分为两组:区域麻醉组和全身麻醉组。记录的变量包括:年龄、性别、美国麻醉医师协会(ASA)评分、合并症、诊所住院时间、死亡率、发病率、术中失血量、输血的必要性以及骨折类型。将这些变量与对照组进行比较并进行回顾性评估。

结果

与全身麻醉组相比,区域麻醉组的诊所住院时间、失血量和输血必要性明显降低(p<0.05)。此外,我们发现全身麻醉的死亡率和发病率明显高于区域麻醉(p<0.05)。最后,我们确定年龄增加和合并症数量增加显著增加了发病率和死亡率(p<0.05)。

结论

本研究评估了区域麻醉在治疗老年髋部骨折方面相对于全身麻醉的优势。这包括降低发病率-死亡率、减少出血和缩短住院时间。

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