Perioperative medicine & outcomes
Effect of spinal versus general anesthesia on thirty-day outcomes following total hip arthroplasty: A matched-pair cohort analysis
Authors' conclusion
Total hip arthroplasty patients receiving spinal anesthesia experience favorable outcomes compared to propensity-matched general anesthesia patients.
Study context
- Population
- Patients undergoing elective total hip arthroplasty, American College of Surgeons NSQIP hospitals, 2015 to 2021matched cohort 2015 to 2018
- Participants
- 96,880 patients
- Exposure
- Spinal vs general anaesthesia for elective total hip arthroplasty
- Spinaln = 48,440
- Generaln = 48,440reference
- Outcome
- Unplanned resource utilization (readmission and reoperation)
- Follow-up
- 30 days
Methodological detailspropensity-matched, 1:1 matched, multicentre registry
- Propensity-matched
- 1:1 matched
- Multicentre registry
Main finding
As reported in the abstract
Unplanned resource utilization
Spinal vs GeneralEstimate (95% CI)P value
Univariate
OR 0.83(0.78–0.90)
P < 0.001Multivariable; c = 0.646
aOR 0.84(0.78–0.90)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Spinal | General | Estimate | P value | |
|---|---|---|---|---|---|
| Systemic complications · 30 daysUnivariate | 1.1% | 1.5% | OR 0.72 (95% CI 0.64–0.80) | P < 0.001 | |
| Systemic complications · 30 daysMultivariable; c = 0.676 | aOR 0.72 (95% CI 0.64–0.81) | ||||
| 0.512Ratio (log scale) |
Days
| Outcome | Spinal | General | Mean difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Hospital LOS | 2.15 | 2.24 | −0.09 (−0.12 to −0.07) | P < 0.001 | |
| −0.15−0.1−0.0500.05Difference (linear scale) |
All outcomes, 2019 to 2021 cohort
- Similar findings observed in the cohort from 2019 to 2021
Safety
| Outcome | Spinal | General | Estimate | P value | |
|---|---|---|---|---|---|
| Bleeding events requiring transfusion · 30 daysUnivariate | 2.3% | 4.9% | OR 0.46 (95% CI 0.42–0.49) | P < 0.001 | |
| Bleeding events requiring transfusion · 30 daysMultivariable; c = 0.686 | aOR 0.46 (95% CI 0.42–0.49) | ||||
| 0.512Ratio (log scale) |
Original publication
Effect of spinal versus general anesthesia on thirty-day outcomes following total hip arthroplasty: A matched-pair cohort analysis. J Clin Anesth. Published 26 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →