General versus spinal anesthesia and early functional and discharge outcomes after geriatric total joint arthroplasty: an NSQIP database retrospective cohort study
Main finding · Functional status declineResult — go to the resultAdjusted odds ratio 1.32 95% CI 1.28–1.37Authors' conclusion
In patients aged 75 years or older undergoing elective total joint arthroplasty, general anesthesia was associated with significantly higher odds of early functional decline and discharge to a non-home setting compared with spinal anesthesia.
Study context
- Population
- Patients aged ≥75 years undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA), American College of Surgeons NSQIP database 2021–2023
- Participants
- 62,338 patients
- Exposure
- General anesthesia (GA) vs spinal anesthesia (SA)
- GAn = 30,296
- SAn = 32,042reference
- Outcome
- Functional status decline (any reduction in activities of daily living independence from preoperative status)
- Follow-up
- Hospital discharge
Methodological detailsregistry database (ACS NSQIP 2021-2023), multivariable logistic regression
- Registry database (ACS NSQIP 2021-2023)
- Multivariable logistic regression
Main finding
Functional status decline
Adjusted odds ratio
1.32
95% CI 1.28–1.37
P < 0.001
By group
GA vs SA
aOR 1.32 (95% CI 1.28–1.37); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Non-home discharge · unadjusted rates
P < 0.001
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Non-home dischargeMultivariable adjusted | 1.70 (1.63–1.78) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
THA and TKA subgroups (subgroup)
- Findings consistent across THA and TKA subgroups
Original publication
General versus spinal anesthesia and early functional and discharge outcomes after geriatric total joint arthroplasty: an NSQIP database retrospective cohort study. Reg Anesth Pain Med. Published 4 May 2026. doi:10.
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