208The Effect of General vs. Regional Anesthesia on Early Postoperative Mortality in Hip Arthroplasty Patients

Abstract

Abstract Background There is conflicting evidence in the literature regarding whether type of anesthesia (regional vs. general) is associated with postoperative mortality in patients undergoing hip arthroplasty. The present study compares mortality between general or regional anesthesia administered to patients undergoing either total (THA) or partial hip arthroplasty (PHA). Methods A retrospective cohort was assembled using the 2015-2016 American College of Surgeons National Surgical Quality Improvement Program database. Adult patients undergoing hip arthroplasty under general or regional anesthesia were included. Adjusted odds of 30 days all-cause postoperative mortality according to type of anesthesia were estimated by fitting multiple logistic regression models that included potential confounders and effect modifiers. Results A total of 60,897 patients were included. Given that the interaction between type of anesthesia and type of arthroplasty was statistically significant, separated models were fitted for each type of arthroplasty. There was no evidence of an association between type of anesthesia and postoperative mortality in hip arthroplasty patients regardless of whether the arthroplasty was partial (OR = 0.85; CI 0.59-1.22) or total (OR = 0.68; CI 0.43-1.08). Conclusion The overall postoperative mortality in adult hip arthroplasty patients is low. Our findings support that mortality is not different between patients receiving regional vs general anesthesia regardless of type of hip arthroplasty (total vs. partial). Key Message In patients undergoing total hip arthroplasty or partial hip arthroplasty, the use of general or regional anesthesia does not impact early postoperative mortality.