Incidence, Risk-factors, and Outcomes of Intraoperative Hypotension Following Spinal Anesthesia in Hip Fracture Surgery: A Retrospective Study from Thailand
1
Issued Date
2024-01-01
Resource Type
eISSN
22288082
Scopus ID
2-s2.0-85200514334
Journal Title
Siriraj Medical Journal
Volume
76
Issue
7
Start Page
396
End Page
405
Rights Holder(s)
SCOPUS
Bibliographic Citation
Siriraj Medical Journal Vol.76 No.7 (2024) , 396-405
Suggested Citation
Jitsinthunun T., Supannanont P., Raksakietisak M. Incidence, Risk-factors, and Outcomes of Intraoperative Hypotension Following Spinal Anesthesia in Hip Fracture Surgery: A Retrospective Study from Thailand. Siriraj Medical Journal Vol.76 No.7 (2024) , 396-405. 405. doi:10.33192/SMJ.V76I7.267837 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/100429
Title
Incidence, Risk-factors, and Outcomes of Intraoperative Hypotension Following Spinal Anesthesia in Hip Fracture Surgery: A Retrospective Study from Thailand
Author(s)
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Objective: Hip fractures are a major health problem in older individuals. Surgical repair is the recommended treatment. Intraoperative hypotension (IOH) due to spinal anesthesia is common and may be associated with unfavorable outcomes. This study aimed to identify the incidence, risk factors, and outcomes of IOH in patients with hip fracture under spinal anesthesia. Materials and Methods: This retrospective study was conducted at a private tertiary hospital in Thailand. Data collected from January 2018 to December 2020 were reviewed. We included all patients aged > 50 years old who underwent hip surgery and excluded those who received general anesthesia, had high-energy or pathological fractures, or had multiple traumas. They were categorized into the no-IOH and IOH groups. The outcome measures were compared between the two groups. Results: In total, 264 patients were included for analysis. The mean age was 80.9 ± 8.3 years, with 77.3% females. The incidence of IOH was 37.9% [95% CI: 30.8%, 46.1%] and an independent risk factor was age > 65 years (OR [95% CI]: 6.23 [1.13, 34.47]. The two protective factors for IOH were higher preoperative mean arterial pressure (OR [95% CI]: 0.96 [0.93, 0.99]) and time from fracture to surgery > 24 hours (OR [95% CI]: 0.43 [0.21, 0.89]). Postoperative blood transfusions were administered more frequently (53.7%) in the IOH group than in the no-IOH group (37.9%, p = 0.014). Conclusion: The incidence of intraoperative hypotension in hip fracture surgery was 38%. Aging is the only identified risk factor. IOH was related to a higher frequency of blood transfusion, but no other postoperative complications or mortality rates.