The relationship between postoperative hypoeosinophilia and hospital stay in patients undergoing hip fracture surgery under general anesthesia or spinal anesthesia: A retrospective study

Abstract

Background The inflammatory immune response is related to the development and progression of many diseases. Recent studies show that eosinophils (EOSs) are involved in various inflammatory processes and even affect patient prognosis. Various anesthetics or anesthesia methods have different effects on the immune inflammatory response. This study aimed to investigate early postoperative changes in EOSs and the relationship of postoperative recovery and hypoeosinophilia in patients undergoing hip fracture surgery under general or spinal anesthesia. Methods We retrospectively analyzed the patients who underwent hip fracture surgery at our hospital between April 2014 and November 2017. Patients were classified according to whether they received general anesthesia or spinal anesthesia. The outcome measure was postoperative hospital stay (days), and the investigating factor was postoperative day 1 EOS levels. Results A total of 149 patients were included in this study, including 34 patients in the general anesthesia group and 115 patients in the spinal anesthesia group. Postoperative day 1 EOS was lower in the general anesthesia group than that in the spinal anesthesia group (P=0.009). The correlation between postoperative hospital stay and postoperative day 1 EOS level was significant ([EOS 1× 107/L increase] β=-0.39, 95%CI -0.74, -0.05) in the general anesthesia group, after adjusting the confounders (age, gender, American Society of Anesthesiologists [ASA] grade, intraoperative blood loss, intraoperative red blood cell [RBC] transfusion, postoperative day 1 hematocrit [HCT] and white blood cell [WBC], and postoperative complications) and the interaction terms for ASA, intraoperative blood loss, intraoperative RBC transfusion and postoperative complications. Conclusion EOSs were significantly decreased after surgery in general anesthesia group, Also, postoperative hospital stay was negatively correlated with postoperative day 1 hypoeosinophilia in the general anesthesia group, suggesting that patients should be closely monitored for EOS changes and postoperative complications to enable early intervention.