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Mode of anesthesia ...
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Mohammad Ismail, Ahmad,1993-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
(author)
Mode of anesthesia is not associated with outcomes following emergency hip fracture surgery : a population-level cohort study
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2022-09-16
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BMJ Publishing Group Ltd,2022
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-101441
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-101441URI
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https://doi.org/10.1136/tsaco-2022-000957DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background: Hip fractures often occur in frail patients with several comorbidities. In those undergoing emergency surgery, determining the optimal anesthesia modality may be challenging, with equipoise concerning outcomes following either spinal or general anesthesia. In this study, we investigated the association between mode of anesthesia and postoperative morbidity and mortality with subgroup analyses.Methods: This is a retrospective study using all consecutive adult patients who underwent emergency hip fracture surgery in Orebro County, Sweden, between 2013 and 2017. Patients were extracted from the Swedish National Hip Fracture Registry, and their electronic medical records were reviewed. The association between the type of anesthesia and 30-day and 90-day postoperative mortality, as well as in-hospital severe complications (Clavien-Dindo classification ≥3a), was analyzed using Poisson regression models with robust SEs, while the association with 1-year mortality was analyzed using Cox proportional hazards models. All analyses were adjusted for potential confounders.Results: A total of 2437 hip fracture cases were included in the study, of whom 60% received spinal anesthesia. There was no statistically significant difference in the risk of 30-day postoperative mortality (adjusted incident rate ratio (IRR) (95% CI): 0.99 (0.72 to 1.36), p=0.952), 90-day postoperative mortality (adjusted IRR (95% CI): 0.88 (0.70 to 1.11), p=0.281), 1-year postoperative mortality (adjusted HR (95% CI): 0.98 (0.83 to 1.15), p=0.773), or in-hospital severe complications (adjusted IRR (95% CI): 1.24 (0.85 to 1.82), p=0.273), when comparing general and spinal anesthesia.Conclusions: Mode of anesthesia during emergency hip fracture surgery was not associated with an increased risk of postoperative mortality or in-hospital severe complications in the study population or any of the investigated subgroups.Level of evidence: Therapeutic/Care Management, level III.
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Added entries (persons, corporate bodies, meetings, titles ...)
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Forssten, Maximilian Peter,1996-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)mmfn
(author)
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Bass, Gary Alan,1979-Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA(Swepub:oru)gbs
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Trivedi, Dhanisha JayeshSchool of Medical Sciences, Örebro University, Örebro, Sweden; Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden
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Ekestubbe, LovisaDivision of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden
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Ioannidis, Ioannis,1967-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)iis
(author)
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Duffy, Caoimhe C.Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Peden, Carol J.Department of Clinical Anesthesiology, University of Southern California Keck School of Medicine, Los Angeles, California, USA; Department of Anesthesiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
(author)
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Mohseni, Shahin,1978-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)snmi
(author)
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Örebro universitetInstitutionen för medicinska vetenskaper
(creator_code:org_t)
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In:Trauma surgery & acute care open: BMJ Publishing Group Ltd7:12397-5776
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