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Postoperative Medical Complications Associated with Anesthesia in Older Adults with Dementia
Author(s) -
Seitz Dallas P.,
Gill Sudeep S.,
Bell Chaim M.,
Austin Peter C.,
Gruneir Andrea,
Anderson Geoff M.,
Rochon Paula A.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13106
Subject(s) - medicine , perioperative , dementia , hip fracture , intensive care unit , confounding , anesthetic , retrospective cohort study , anesthesia , cohort study , propensity score matching , surgery , osteoporosis , disease
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, C anada. Participants All older adults with dementia who underwent surgery for hip fracture repair in O ntario, C anada, between A pril 1, 2003 and M arch 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.