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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Main Authors: Yu Zhang, Xuemei Tan, Xiaoxia Duan, Xiaohui Du, Jiang Zheng, Lan Feng, Hong Fu
Format: Article
Language:English
Published: BMC 2025-04-01
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
collection DOAJ
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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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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