Table 3.
Influence of anaesthesia type on perioperative outcomes in total hip arthroplasty. CI, confidence interval; GA, general anaesthesia; MI, myocardial infarction; NA, neuraxial anaesthesia; OR, odds ratio; PE, pulmonary embolism. All infections, including pneumonia and sepsis; pulmonary complications, excluding pneumonia; n (NA/GA): total number of patients with NA/GA.
| Complication | NA vs GA |
NA+GA vs GA |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Studies | OR (95% CI) | n (NA) | n (GA) | P-value | Studies | OR (95% CI) | n (NA) | n (GA) | P-value | |
| Mortality | Various authors5, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36 | 0.67 (0.57–0.80) | 60 499 | 148 583 | <0.0001 | Various authors5, 30 | 0.58 (0.38–0.89) | 15 331 | 98 230 | 0.014 |
| Cardiac including MI | Various authors5, 28, 32, 33, 34, 37 | 0.94 (0.88–1.02) | 28 182 | 121 215 | 0.135 | Various authors5, 38 | 0.76 (0.54–1.07) | 15 281 | 98 139 | 0.113 |
| Cardiac excluding MI | Various authors5, 27, 32, 33, 34 | 0.96 (0.88–1.03) | 32 639 | 133 832 | 0.255 | Memtsoudis and colleagues5 | 1.01 (0.95–1.09) | 15 261 | 98 122 | 0.689 |
| MI | Various authors5, 33, 34, 37 | 0.94 (0.71–1.24) | 23 022 | 115 759 | 0.647 | Various authors5, 38 | 0.76 (0.54–1.07) | 15 281 | 98 139 | 0.113 |
| Pulmonary | Various authors5, 28, 33 | 0.65 (0.52–0.80) | 28 029 | 121 058 | <0.0001 | Memtsoudis and colleagues5 | 0.66 (0.52–0.84) | 15 261 | 98 122 | 0.001 |
| Pneumonia | Various authors5, 33, 34, 37 | 0.69 (0.56–0.84) | 23 022 | 115 759 | <0.0001 | Memtsoudis and colleagues5 | 0.88 (0.74–1.05) | 15 261 | 98 122 | 0.165 |
| Gastrointestinal | Memtsoudis and colleagues5 | 0.83 (0.67–1.02) | 11 610 | 98 122 | 0.078 | Memtsoudis and colleagues5 | 0.79 (0.65–0.95) | 15 261 | 98 122 | 0.013 |
| Acute renal failure | Various authors5, 33, 37, 39, 40 | 0.69 (0.59–0.81) | 34 366 | 133 687 | <0.0001 | Memtsoudis and colleagues5 | 0.75 (0.65–0.86) | 15 261 | 98 122 | <0.0001 |
| Urinary retention | Various authors34, 39, 40, 41, 42, 43 | 3.05 (1.98–4.69) | 252 | 628 | <0.0001 | Various authors44, 45 | 1.91 (1.05–3.48) | 123 | 163 | 0.035 |
| Urinary tract infection | Various authors30, 33 | 0.86 (0.70–1.06) | 11 334 | 17 648 | 0.164 | Brinker and colleagues30 | 1.14 (0.43–2.99) | 70 | 108 | 0.793 |
| DVT | Various authors30, 33, 36, 41, 43, 46, 47, 48, 49, 50, 51, 52, 53 | 0.52 (0.42–0.65) | 15 688 | 20 477 | <0.0001 | Various authors30, 38 | 0.81 (0.17–3.89) | 90 | 125 | 0.795 |
| PE | Various authors5, 33, 34, 35, 36, 37, 41, 48, 49, 50, 51, 52, 53 | 0.63 (0.50–0.81) | 34 875 | 123 934 | <0.0001 | Memtsoudis and colleagues5 | 0.68 (0.46–1.03) | 15 261 | 98 122 | 0.066 |
| DVT+PE | Various authors5, 30, 33, 34, 35, 36, 37, 41, 43, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57 | 0.61 (0.53–0.71) | 59 573 | 157 731 | <0.0001 | Various authors5, 30, 38 | 0.69 (0.47–1.02) | 15 351 | 98 247 | 0.065 |
| CNS | Various authors5, 33, 58 | 0.39 (0.23–0.65) | 22 977 | 115 712 | <0.0001 | Various authors5, 34, 59 | 0.68 (0.42–1.09) | 15 306 | 98 162 | 0.112 |
| Stroke | Various authors5, 33 | 0.37 (0.22–0.64) | 22 927 | 115 662 | <0.0001 | Memtsoudis and colleagues5 | 0.71 (0.44–1.16) | 15 261 | 98 122 | 0.176 |
| All infections | Various authors5, 28, 30, 33, 34, 37 | 0.73 (0.67–0.79) | 62 385 | 254 465 | <0.0001 | Various authors5, 30 | 0.86 (0.79–0.92) | 30 592 | 196 352 | <0.0001 |
| Wound (superficial) | Various authors30, 33, 34 | 1.21 (0.93–1.56) | 11 363 | 17 679 | 0.152 | Brinker and colleagues30 | 1.56 (0.21–11.33) | 70 | 108 | 0.661 |
| Wound (deep) | Various authors28, 33, 54 | 0.86 (0.70–1.06) | 24 603 | 35 688 | 0.159 | |||||
| Blood transfusion | Various authors5, 30, 33, 34, 37, 41, 43, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69 | 0.85 (0.82–0.89) | 25 033 | 117 443 | <0.0001 | Various authors5, 30, 38, 61 | 0.78 (0.75–0.82) | 15 421 | 98 317 | <0.0001 |
| Critical care | Various authors27, 33 | 0.80 (0.49–1.32) | 20 690 | 33 125 | 0.387 | |||||
| Readmission | Haughom and colleagues33 | 0.91 (0.80–1.04) | 11 317 | 17 540 | 0.161 | |||||
| Nerve injury | Various authors30, 33, 34, 69 | 0.81 (0.56–1.18) | 19 842 | 27 106 | 0.278 | Brinker and colleagues30 | 0.30 (0.01–6.39) | 70 | 108 | 0.442 |
| Falls | Kendrišić and colleagues71 | 0.81 (0.72–0.92) | 20 985 | 145 886 | 0.001 | |||||
| Blood loss (ml) | Various authors36, 43, 50, 51, 52, 60, 61, 62, 66, 68, 72, 73, 74, 75, 76, 77 | –146.12 (–173.73 to –118.51) | 902 | 644 | <0.0001 | Various authors38, 59, 61, 74, 77, 78, 79 | –20.13 (–50.10 to 9.83) | 226 | 216 | 0.188 |
| Length of stay (days) | Various authors28, 80 | –0.16 (–0.22 to –0.10) | 5146 | 5442 | <0.0001 | Benson and colleagues59 | –6.00 (–14.77 to 2.77) | 16 | 9 | 0.18 |
| Blood transfusion (ml) | Various authors43, 50, 51, 60, 66 | –187.83 (–272.29 to –103.38) | 310 | 195 | <0.0001 | |||||