Table 1.
Characteristics | Anesthesia type | ||
---|---|---|---|
General (n=61 554) | Regional (n=6939) | General and regional (n=4791) | |
Personal characteristics | |||
Median (interquartile range) age (years) | 82 (74-88) | 83 (77-88) | 83 (76-88) |
Age groups (years): | |||
18-54 | 2235 (3.6) | 99 (1.4) | 88 (1.8) |
55-69 | 8224 (13.4) | 681 (9.8) | 531 (11.1) |
70-79 | 13 941 (22.6) | 1581 (22.8) | 1107 (23.1) |
80-84 | 12 830 (20.8) | 1540 (22.2) | 1026 (21.4) |
≥85 | 24 324 (39.5) | 3038 (43.8) | 2039 (42.6) |
Women | 43 527 (70.7) | 5063 (73.0) | 3429 (71.6) |
Ethnicity: | |||
White | 48 768 (79.2) | 5068 (73.0) | 4084 (85.2) |
Black | 2949 (4.8) | 211 (3.0) | 247 (5.2) |
Hispanic | 1938 (3.1) | 594 (8.6) | 39 (0.8) |
Other or unknown | 7899 (12.8) | 1066 (15.4) | 421 (8.8) |
Hospitalization and surgery characteristics | |||
Type of admission: | |||
Emergency room | 34 852 (56.6) | 4322 (62.3) | 2676 (55.9) |
Non-healthcare facility | 18 554 (30.1) | 1817 (26.2) | 1342 (28.0) |
Other* | 8148 (13.3) | 800 (11.5) | 773 (16.1) |
Median (interquartile range) days before surgery | 1 (1-2) | 1 (1-2) | 1 (1-2) |
Type of surgical procedure: | |||
Closed reduction of fracture | 14 359 (23.3) | 1483 (21.4) | 1047 (21.9) |
Open reduction of fracture | 21 541 (35.0) | 2398 (34.6) | 1470 (30.7) |
Total hip replacement | 2622 (4.3) | 297 (4.3) | 232 (4.8) |
Partial hip replacement | 23 252 (37.8) | 2790 (40.2) | 2067 (43.1) |
Other hip procedure | 3598 (5.9) | 362 (5.2) | 336 (7.0) |
Comorbidities | |||
Type of fracture: | |||
Transcervical fracture | 15 951 (25.9) | 1974 (28.4) | 1332 (27.8) |
Intertrochanteric fracture | 26 874 (43.7) | 2988 (43.1) | 1941 (40.5) |
Subtrochanteric fracture | 3831 (6.2) | 365 (5.3) | 243 (5.1) |
Trochanteric fracture | 1299 (2.1) | 152 (2.2) | 106 (2.2) |
Unspecified part of neck of femur | 23 754 (38.6) | 2680 (38.6) | 1978 (41.3) |
Disease related fracture of neck of femur | 1813 (2.9) | 168 (2.4) | 111 (2.3) |
Median (interquartile range) Charlson comorbidity score | 1 (0-2) | 1 (0-2) | 1 (0-2) |
Chronic hypertension | 44 521 (72.3) | 5014 (72.3) | 3499 (73.0) |
Diabetes | 14 877 (24.2) | 1508 (21.7) | 1049 (21.9) |
Previous myocardial infarction | 4966 (8.1) | 568 (8.2) | 378 (7.9) |
Chronic heart failure | 11 020 (17.9) | 1166 (16.8) | 838 (17.5) |
Chronic obstructive pulmonary disease | 11 216 (18.2) | 1577 (22.7) | 1070 (22.3) |
Chronic renal disease | 10 513 (17.1) | 1023 (14.7) | 833 (17.4) |
Dementia | 17 254 (28.0) | 2081 (30.0) | 1459 (30.5) |
Cancer | 4191 (6.8) | 405 (5.8) | 303 (6.3) |
Inpatient use of drugs and services before surgery | |||
Angiotensin converting enzyme inhibitor | 8937 (14.5) | 933 (13.4) | 673 (14.0) |
β blocker | 21 362 (34.7) | 2258 (32.5) | 1582 (33.0) |
Calcium channel blocker | 9113 (14.8) | 1020 (14.7) | 710 (14.8) |
Nitrates | 2391 (3.9) | 254 (3.7) | 175 (3.7) |
Loop diuretics | 8532 (13.9) | 878 (12.7) | 676 (14.1) |
Antidiabetes drugs | 9043 (14.7) | 919 (13.2) | 664 (13.9) |
Statin | 13 526 (22.0) | 1285 (18.5) | 974 (20.3) |
Aspirin | 4166 (6.8) | 393 (5.7) | 355 (7.4) |
Warfarin | 374 (0.6) | 25 (0.4) | 26 (0.5) |
Intravenous heparin | 900 (1.5) | 81 (1.2) | 61 (1.3) |
Intensive care unit admission | 4767 (7.7) | 432 (6.2) | 259 (5.4) |
Oxygen use | 12 568 (20.4) | 1741 (25.1) | 1267 (26.4) |
Dialysis | 1254 (2.0) | 104 (1.5) | 68 (1.4) |
Packed red blood cells transfusion: | |||
0 unit | 55 024 (89.4) | 6393 (92.1) | 4290 (89.5) |
1 unit | 2010 (3.3) | 202 (2.9) | 139 (2.9) |
≥ 2 units | 4520 (7.3) | 344 (5.0) | 362 (7.6) |
Hospital characteristics | |||
Teaching hospital | 22 114 (35.9) | 1318 (19.0) | 1273 (26.6) |
Urban hospital | 54 790 (89.0) | 5805 (83.7) | 3650 (76.2) |
Age and Charlson comorbidity score were modeled as categorical variables in the multivariable logistic models. Additional covariates that were included in the multivariable logistic models include marital status; year of admission; hyperlipidemia; history of percutaneous coronary procedure; other forms of ischemic heart disease; chronic cardiac dysrhythmia; previous stroke; liver disease; chronic hemostatic disorders; osteoarthritis; rheumatoid arthritis; obesity; smoking (former or current); alcohol or drug misuse or dependence; history of peptic ulcer disease; unintentional fall; angiotensin receptor blockers, thiazide diuretics; aldosterone antagonists; digoxin; rhythm control drugs; treatment for chronic obstructive respiratory diseases (inhaled β2 agonists, inhaled steroids, leukotriene inhibitors, ipratropium, or theophylline); other antiplatelets; subcutaneous anticoagulants; systemic corticosteroids; telemetry; echocardiography; fresh frozen plasma transfusion; thirds of hip fracture surgery volume; and region.
*Includes admission from clinic; admission from court or law enforcement; transfer from ambulatory surgery center; transfer from another home health agency; transfer from same hospital, separate claim; transfer from other healthcare facility; transfer from hospice; transfer from skilled nursing facility or intermediate care facility; transfer from a hospital (different facility); information not available.