Abstract:

OBJECTIVE: Hip replacement surgery is a common procedure in elderly patients and may result in high morbidity and mortality. In this study, we aimed to investigate the effects of anesthesia methods on postoperative renal function, postoperative intensive care unit admission and mortality in elderly patients undergoing hip replacement. MATERIAL AND METHODS: In our study, computer records of patients aged 75 years and older who underwent hip replacement in our hospital between October 1, 2013 and October 1, 2018 were reviewed retrospectively. These patients were divided into two groups as those undergoing general anesthesia (Group G) and those under regional anesthesia (Group R). Gender, comorbidities, early mortality (7days), postoperative intensive requirements, perioperative creatinine, hematocrit and blood urea nitrogen (BUN) values, postoperative acute renal failure, hospital stay were compared. Patients with renal insufficiency, patients whose data were not fully available and patients younger than 75 years of age at the time of surgery were excluded from the study. RESULTS: Of the 351 patients who had hip replacement surgery, 68 patients aged 75 years and older were included in the study (Group G = 53 patients, Group R = 15 patients). There was no difference between the groups in the demographic data (age, gender, comorbidity). Postoperatively, 89.7 % of the patients went to the ward and 10.3% of them went to the intensive care unit, and there was no significant difference between the two groups (p = 0.661). Duration of hospital stay was 9 days in Group G, 8 days in Group R, and there was no statistical difference between the groups (p = 0.153). Mortality was determined in 5.9 % of all patients, and there was no difference between the groups (p = 0.115). Postoperative acute renal failure was observed in 9.4% of the general group and 13.3% in the regional group, but there was no significant difference between the groups (p = 0.661). When the preoperative, postoperative 1st-day, and postoperative 7th-day biochemical values (creatinine, BUN, hematocrit) were examined, no significant difference was observed between the two groups. CONCLUSIONS: Hip replacement surgery is a common procedure in elderly patients and may result in high morbidity and mortality due to the characteristics of both patients and surgery. The choice of anesthesia method, physiological changes in the elderly, and comorbidities affect perioperative mortality and morbidity. In conclusion, the effects of general and regional anesthesia techniques were found to be similar in terms of short-term mortality and postoperative renal function after hip replacement surgery in the elderly.

Keywords: