دورية أكاديمية

Impact of regional anesthesia on outcomes of geriatric patients undergoing lower extremity revascularization: A propensity score-matched cohort study

التفاصيل البيبلوغرافية
العنوان: Impact of regional anesthesia on outcomes of geriatric patients undergoing lower extremity revascularization: A propensity score-matched cohort study
المؤلفون: Lim, Jung A, Seo, Yohan, Choi, Eun-Joo, Kwak, Sang Gyu, Ryu, Taeha, Lee, Jae Hoon, Park, Ki Hyuk, Roh, Woon Seok
المصدر: Medicine ; volume 101, issue 52, page e32597 ; ISSN 1536-5964
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2022
الوصف: Lower extremity revascularization (LER) for peripheral artery disease in elderly patients is associated with a high risk of perioperative morbidity and mortality. This study aimed to a conduct retrospective review and propensity score matching analysis to determine whether the use of regional anesthesia (RA) instead of general anesthesia (GA) in geriatric patients undergoing LER for peripheral artery disease results in improved short-term mortality and health outcomes. We reviewed medical records of 1271 patients aged >65 years who underwent LER at our center between May 1998 and February 2016. According to the anesthesia method, patients were grouped in the GA and RA groups. The primary outcome was short-term mortality (7-day and 30-day). The secondary outcomes were 5-year survival rate, intraoperative events, postoperative morbidity, and postoperative length of stay. A propensity score-matched cohort design was used to control for potentially confounding factors including patient demographics, comorbidities, American Society of Anesthesiologists physical status, and preoperative medications. After propensity score matching, 722 patients that received LER under GA (n = 269) or RA (n = 453) were identified. Patients from the GA group showed significantly higher 7-day mortality than those from the RA group (5.6% vs 2.7% P = .048); however, there was no significant difference in 30-day mortality between the groups (GA vs RA: 6.3% vs 3.6%, P = .083). The 5-year survival rate and incidence of arterial and central venous catheter placement or intraoperative dopamine and epinephrine use were significantly higher in the GA group than in the RA group ( P < .05). In addition, the frequency of immediate postoperative oxygen therapy or mechanical ventilation support was higher in the GA group ( P < .05). However, there was no difference in the postoperative cardiopulmonary and cerebral complications between the 2 groups. These results suggest that RA can reduce intraoperative hemodynamic support and provide ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1097/md.0000000000032597
DOI: 10.1097/MD.0000000000032597
الإتاحة: https://doi.org/10.1097/md.0000000000032597Test
حقوق: http://creativecommons.org/licenses/by-nc/4.0Test/
رقم الانضمام: edsbas.7BE40D1E
قاعدة البيانات: BASE