Postoperative Medical Complications Associated with Anesthesia in Older Adults with Dementia. Issue 11 (4th November 2014)

• Record Type: Journal Article
• Authors: Seitz, Dallas P.; Gill, Sudeep S.; Bell, Chaim M.; Austin, Peter C.; Gruneir, Andrea; Anderson, Geoff M.; Rochon, Paula A.
• Is Part Of: Journal of the American Geriatrics Society. Volume 62:Issue 11(2014:Nov.)
• Page Start: 2102
• Page End: 2109
• Publication Date: 2014-11-04
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.13106
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" id="jgs13106-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs13106-sec-0001" sec-type="section"> <title>Objectives</title> <p>To examine the association between anesthetic technique and postoperative complications in older adults with dementia undergoing hip fracture surgery.</p> </sec> <sec id="jgs13106-sec-0002" sec-type="section"> <title>Design</title> <p>Population‐based, retrospective cohort study.</p> </sec> <sec id="jgs13106-sec-0003" sec-type="section"> <title>Setting</title> <p>Ontario, Canada.</p> </sec> <sec id="jgs13106-sec-0004" sec-type="section"> <title>Participants</title> <p>All older adults with dementia who underwent surgery for hip fracture repair in Ontario, Canada, between April 1, 2003 and March 31, 2011.</p> </sec> <sec id="jgs13106-sec-0005" sec-type="section"> <title>Measurements</title> <p>The baseline characteristics of individuals who received general anesthesia (GA) and regional anesthesia (RA) were compared. Individuals who received GA were matched to similar individuals who received RA using propensity scores to control for confounding, and their outcomes compared, including 30‐day mortality, intensive care unit (ICU) admissions, specific postoperative medical complications, and hospital length of stay (LOS).</p> </sec> <sec id="jgs13106-sec-0006" sec-type="section"> <title>Results</title> <p>In the 6, 135 matched pairs, there was no statistically significant difference in postoperative 30‐day mortality (GA, 11.3%; RA, 10.8%, <italic>P</italic> = .44). There were no statistically significant differences in the rates of specific postoperative medical complications or LOS in the two anesthetic groups, but GA was associated with higher rates of ICU admissions (6.1% vs 4.2%, <italic>P</italic> < .001).</p> </sec> <sec id="jgs13106-sec-0007" sec-type="section"> <title>Conclusion</title> <p>For older adults with dementia undergoing hip fracture surgery, GA and RA are associated with similar rates of most perioperative adverse events. Further studies are required to determine the optimal methods of providing anesthesia and perioperative care for older adults with dementia undergoing surgical procedures.</p> </sec> </abstract>