The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched study
Abstract Purpose This study aimed to assess the impact of different anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old. Patients and methods We retrospectively reviewed the medical records of elderly patients over 90 years old who underwent low...
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BMC
2025-04-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-03035-9 |
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| author | Yu Zhang Xuemei Tan Xiaoxia Duan Xiaohui Du Jiang Zheng Lan Feng Hong Fu |
| author_facet | Yu Zhang Xuemei Tan Xiaoxia Duan Xiaohui Du Jiang Zheng Lan Feng Hong Fu |
| author_sort | Yu Zhang |
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| description | Abstract Purpose This study aimed to assess the impact of different anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old. Patients and methods We retrospectively reviewed the medical records of elderly patients over 90 years old who underwent lower limb surgeries at Chongqing University Center Hospital, the Affiliated Hospital of Southwest Medical University, and Chongqing General Hospital from January 2012 to December 2022. The patients were categorized into two groups based on the anesthesia method employed: the general anesthesia (GA) group and the regional anesthesia (RA) group. To minimize potential confounding, propensity score matching (PSM) was conducted in a 1:1 ratio with the caliper value set as 0.1; additionally, further univariable logistic regression was employed to compare the risk of postoperative complications and mortality between the GA and RA groups. Results A total of 560 patients were included in our analysis, with 363 cases receiving general anesthesia (GA) and 197 cases receiving regional anesthesia (RA). After conducting propensity score matching (PSM), 139 pairs of data were successfully matched. Compared with the RA group, the GA group had a higher risk of postoperative complications (32.4% vs. 19.4%;OR,1.99; 95% CI, 1.15–3.44; p = 0.015), a higher risk of postoperative ICU admission (44.6% vs. 20.9%;OR,3.05; 95% CI,1.80–5.18;p < 0.001), but a lower risk of intraoperative blood transfusion (46% vs. 59%;OR,0.59; 95% CI,0.37–0.95;P = 0.031).No statistically significant differences were observed in other perioperative indices between the two groups. Conclusion In elderly patients over 90 years old undergoing lower limb fracture surgeries, GA is associated with a higher risk of postoperative complications and ICU admission compared to RA. Furthermore, compared with RA, GA is associated with a decreased need for intraoperative blood transfusion. Trial registration The study was registered in the Chinese Clinical Trial Registry (ChiCTR2400083103, principal investigator: Hong Fu, 14/04/2024). |
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| publishDate | 2025-04-01 |
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| spelling | doaj-art-34bece31b8bb401290a8406ff869b0262025-08-20T02:28:07ZengBMCBMC Anesthesiology1471-22532025-04-012511810.1186/s12871-025-03035-9The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched studyYu Zhang0Xuemei Tan1Xiaoxia Duan2Xiaohui Du3Jiang Zheng4Lan Feng5Hong Fu6Department of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing UniversityDepartment of Anesthesiology, Chongqing General Hospital, Chongqing UniversityDepartment of Anesthesiology, The Affiliated Hospital of Southwest Medical UniversityDepartment of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing UniversityDepartment of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing UniversityDepartment of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing UniversityDepartment of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing UniversityAbstract Purpose This study aimed to assess the impact of different anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old. Patients and methods We retrospectively reviewed the medical records of elderly patients over 90 years old who underwent lower limb surgeries at Chongqing University Center Hospital, the Affiliated Hospital of Southwest Medical University, and Chongqing General Hospital from January 2012 to December 2022. The patients were categorized into two groups based on the anesthesia method employed: the general anesthesia (GA) group and the regional anesthesia (RA) group. To minimize potential confounding, propensity score matching (PSM) was conducted in a 1:1 ratio with the caliper value set as 0.1; additionally, further univariable logistic regression was employed to compare the risk of postoperative complications and mortality between the GA and RA groups. Results A total of 560 patients were included in our analysis, with 363 cases receiving general anesthesia (GA) and 197 cases receiving regional anesthesia (RA). After conducting propensity score matching (PSM), 139 pairs of data were successfully matched. Compared with the RA group, the GA group had a higher risk of postoperative complications (32.4% vs. 19.4%;OR,1.99; 95% CI, 1.15–3.44; p = 0.015), a higher risk of postoperative ICU admission (44.6% vs. 20.9%;OR,3.05; 95% CI,1.80–5.18;p < 0.001), but a lower risk of intraoperative blood transfusion (46% vs. 59%;OR,0.59; 95% CI,0.37–0.95;P = 0.031).No statistically significant differences were observed in other perioperative indices between the two groups. Conclusion In elderly patients over 90 years old undergoing lower limb fracture surgeries, GA is associated with a higher risk of postoperative complications and ICU admission compared to RA. Furthermore, compared with RA, GA is associated with a decreased need for intraoperative blood transfusion. Trial registration The study was registered in the Chinese Clinical Trial Registry (ChiCTR2400083103, principal investigator: Hong Fu, 14/04/2024).https://doi.org/10.1186/s12871-025-03035-9AnesthesiaElderlyLower limb surgeryPostoperative outcomesPropensity matching |
| spellingShingle | Yu Zhang Xuemei Tan Xiaoxia Duan Xiaohui Du Jiang Zheng Lan Feng Hong Fu The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched study BMC Anesthesiology Anesthesia Elderly Lower limb surgery Postoperative outcomes Propensity matching |
| title | The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched study |
| title_full | The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched study |
| title_fullStr | The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched study |
| title_full_unstemmed | The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched study |
| title_short | The impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old: A multicenter propensity-matched study |
| title_sort | impact of anesthesia methods on postoperative outcomes of lower limb surgeries in elderly patients over 90 years old a multicenter propensity matched study |
| topic | Anesthesia Elderly Lower limb surgery Postoperative outcomes Propensity matching |
| url | https://doi.org/10.1186/s12871-025-03035-9 |
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