Background and aims There are various reports on the effect of the anesthetic method on neurologic complication. Especially, there is controversy about the effect of general anesthesia and regional anesthesia on incidence of postoperative delirium after total hip replacement arthroplasty (THRA). a population-based study was conducted to estimate the effect of anesthetic method on the incidence of postoperative delirium in patients with THRA on South Korea.
Methods The Korean National Health Insurance (NHI) claims database of 24,379 cases were retrospectively collected and analyzed to identify THRA, defined as patients having a claim record with the operation code ‘N0711’ from January 2008 to December 2017. Patients were divided into 2 groups: GA group (n = 9,921) and RA group (n = 14,458). the incidence of delirium was assessed in cases when delirium medications such as haloperidol, chlorpromazine, olanzapine and risperidone were used. To identify factors significantly predictive of postoperative delirium, univariate and multivariable logistic regression analyses were performed.
Results Among them, 142/9,921 (1.43%) in GA group and 209/14,458 (0.86%) in RA group occurred postoperative delirium after THRA. There was no significant difference between groups (P = 0.92). In logistic regression analysis, gender and hospital stay were related with postoperative delirium. of the patients with delirium, delirium occurred 1.97 times more frequently in men [233 (66.38%)] than in women [118 (33.62%)].
Conclusions Our results revealed that anesthetic methods were not associated with the incidence of postoperative delirium. In addition, male patients undergoing THRA should be managed with caution for postoperative delirium.
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