Spinal Anesthesia Associated With Increased Length of Stay Compared to General Anesthesia for Ankle Open Reduction Internal Fixation: A Propensity-Matched Analysis

Vora, Molly; Samineni, Aneesh V.; Sing, David C.; Salavati, Seroos; Tornetta, Paul

doi:10.1053/j.jfas.2020.08.035

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…Contrary to the findings of our study, Vora et al reported that patients with spinal anesthesia for ankle ORIF had a longer length of stay in the hospital [ 18 ].…”

Section: Discussioncontrasting

confidence: 99%

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Does the type of anesthesia (regional vs. general) represent an independent predictor for in-hospital complications in operatively treated malleolar fractures? A retrospective analysis of 5262 patients

Canal

Kaserer

Morax

et al. 2023

Eur J Trauma Emerg Surg

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Purpose The impact of the type of anesthesia (regional vs. general anesthesia) on in-hospital complications in ankle fractures has not been thoroughly studied yet. Identifying factors that place patients at risk for complications following ankle fractures may help reduce their occurrence. The primary goal of this study was (1) to describe the cohort of patients and (2) to evaluate independent risk factors for complications during hospitalization. Methods We analyzed patients from 2005 to 2019 with an operatively treated isolated fracture of the medial or lateral malleolus using a prospective national quality measurement database. Patients were selected based on international classifications (ICD) and national procedural codes (CHOP). Uni- and multivariate analysis were applied. Results In total, we analyzed 5262 patients who suffered a fracture of the malleolus; 3003 patients (57%) had regional and 2259 (43%) general anesthesia. Patients with regional anesthesia were significantly older (51 vs. 46 years), but healthier (23 vs. 28% comorbidities) than patients who received general anesthesia. The in-hospital complication rate was not significantly lower in regional anesthesia (2.2% vs 3.0%). The type of anesthesia was not an independent predictor for complications while controlling for confounders. Conclusion Type of anesthesia was not an independent predictor of complications; however, higher ASA class, age over 70 years, fracture of the medial versus lateral malleolus, longer preoperative stay, and duration of surgery were significant predictors of complications. Patient and procedure characteristics, as well as changes in medical care and epidemiological changes along with patient requests, influenced the choice of the type of anesthesia.

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“…Contrary to the findings of our study, Vora et al reported that patients with spinal anesthesia for ankle ORIF had a longer length of stay in the hospital [ 18 ].…”

Section: Discussioncontrasting

confidence: 99%

“…Anesthesia type was not an independent predictor for complications after controlling for confounders. This main finding aligns with previous research [ 18 , 19 ] who showed no differences in complications and mortality comparing spinal and general anesthesia in ankle fractures.…”

Section: Discussionsupporting

confidence: 92%

Does the type of anesthesia (regional vs. general) represent an independent predictor for in-hospital complications in operatively treated malleolar fractures? A retrospective analysis of 5262 patients

Canal

Kaserer

Morax

et al. 2023

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

show abstract

“…However, similar proportions of same-day discharge were observed in our propensity score–matched cohorts. Compared with GA, neuraxial RA may be associated with an increased risk of self-limited postoperative urinary retention and lower extremity weakness 7,18 . This has been associated with increased postanesthesia care unit length of stay and could conceivably lead to the increased likelihood of hospital admission 17 .…”

Section: Discussionmentioning

confidence: 99%

“…weakness. 7,18 This has been associated with increased postanesthesia care unit length of stay and could conceivably lead to the increased likelihood of hospital admission. 17 A retrospective study by Alas et al 19 found that spinal anesthesia was not associated with postoperative urinary retention among patients discharged the same day after vaginal pelvic floor procedures, although the authors notably excluded patients who required overnight stay.…”

mentioning

confidence: 99%

Vaginal Hysterectomy Performed Under General Versus Neuraxial Regional Anesthesia: Comparison of Patient Characteristics and 30-Day Outcomes Using Propensity Score–Matched Cohorts

Hong

Kim

Cardi

et al. 2022

Female Pelvic Med Reconstr Surg

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ObjectivesCompared with surgery under general anesthesia (GA), surgery under neuraxial regional anesthesia (RA) has been associated with economic and clinical benefits in certain populations. Our aim was to compare preoperative and postoperative characteristics and 30-day outcomes, including intraoperative complications, for patients undergoing benign vaginal hysterectomy under GA versus RA.MethodsThis is a retrospective cohort study of patients who underwent vaginal hysterectomy for benign indications between 2015 and 2019 using the American College of Surgeons National Surgical Quality Improvement Program database. Patients were identified using Current Procedural Terminology codes and stratified into GA and RA groups. Propensity score matching was performed to account for selection bias between anesthesia groups.ResultsOf 18,030 vaginal hysterectomies performed during this study period, 17,472 (96.9%) were performed under GA and 558 (3.1%) under RA. The RA group was older, more likely to be White, and more likely to have a history of chronic obstructive pulmonary disease and chronic steroid use (P < 0.01 for all); they were less likely to be discharged the same day (8.6% vs 12.2%, P = 0.01). In the matched cohort, there were similar proportions of major, minor, and composite complications between RA and GA groups (major: odds ratio [OR], 0.95; 95% confidence interval [CI], 0.51–1.78; minor: OR, 1.18; 95% CI, 0.74–1.88; composite: OR, 1.10; 95% CI, 0.75–1.64). Similar proportions of same-day discharge were observed (OR, 0.72; 95% CI, 0.47–1.10).ConclusionsAlthough RA comprises only 3% of the anesthetic modalities used for benign vaginal hysterectomies, it is associated with a similar incidence of postoperative complications compared with general anesthesia.

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Postoperative complications of spinal vs general anesthesia in elderly patients undergoing hip hemiarthroplasty

Chowdary

Martínez

Aggarwal

et al. 2023

Arch Orthop Trauma Surg

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Spinal Anesthesia Associated With Increased Length of Stay Compared to General Anesthesia for Ankle Open Reduction Internal Fixation: A Propensity-Matched Analysis

Cited by 4 publications

References 26 publications

Does the type of anesthesia (regional vs. general) represent an independent predictor for in-hospital complications in operatively treated malleolar fractures? A retrospective analysis of 5262 patients

Does the type of anesthesia (regional vs. general) represent an independent predictor for in-hospital complications in operatively treated malleolar fractures? A retrospective analysis of 5262 patients

Vaginal Hysterectomy Performed Under General Versus Neuraxial Regional Anesthesia: Comparison of Patient Characteristics and 30-Day Outcomes Using Propensity Score–Matched Cohorts

Postoperative complications of spinal vs general anesthesia in elderly patients undergoing hip hemiarthroplasty

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