Summary of "Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults"

This study compared the effects of spinal versus general anesthesia on outcomes among older adults undergoing hip fracture surgery. The primary outcome was a composite of death or inability to walk 10 feet, independently or with a walker/cane, at 60 days. Secondary outcomes included death within 60 days, delirium, time to discharge, and ambulation at 60 days. Among the 1600 previously ambulatory patients, 50 years and older, patients were randomized to receive spinal or general anesthesia. The study results demonstrated that the incidence of the primary outcome did not differ between the two groups, occurring in 18.5% of spinal anesthesia patients versus 18.0% of general anesthesia patients (relative risk [RR], 1.03; 95% confidence interval [CI], 0.84-1.27). Furthermore, the incidence of secondary outcomes also did not differ between groups. It was concluded that spinal anesthesia was not superior to general anesthesia for hip fracture repair in this patient population. In addition, the incidence of postoperative delirium was similar with the two types of anesthesia.