Evaluating the Association of Anesthesia Type With Postoperative Complications in Patients Undergoing Ankle Fracture Repair

Authors

Theodore Quan, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address: teddyquan@gwu.edu.
Alisa Malyavko, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Anna M. Ifarraguerri, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Yumin Kim, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Lea Mcdaniel, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Joseph E. Manzi, Weill Cornell Medical College, New York, NY.
Amil R. Agarwal, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Frank R. Chen, Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, PA.
Alex Gu, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Sean Tabaie, Department of Orthopaedic Surgery, Children's National Health System, Washington, DC.

Document Type

Journal Article

Publication Date

1-31-2022

Journal

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons

DOI

10.1053/j.jfas.2022.01.025

Keywords

ankle fracture; complications; general anesthesia; internal fixation; neuraxial anesthesia; open reduction

Abstract

General and neuraxial anesthesia are both successful anesthesia techniques used in many orthopedic procedures. The purpose of this study was to compare the complications and length of hospital stay between patients who underwent general anesthesia versus neuraxial anesthesia during the repair of ankle fractures. Patients undergoing open reduction and internal fixation for ankle fracture from 2014 to 2018 were identified in the National Surgical Quality Improvement Program database. Patients were stratified into 2 cohorts: general anesthesia and neuraxial anesthesia. In this analysis, demographics data, comorbidities, and postoperative complications were collected and compared between the two cohorts. Bivariate analyses and multivariable logistical regression were performed. Of 3585 patients who underwent operative treatment for ankle fracture, 3315 patients (92.5%) had general anesthesia and 270 (7.5%) had neuraxial anesthesia. On bivariate analyses, patients who had neuraxial anesthesia were more likely to develop pulmonary complications (p = .173) or extended length of stay more than 5 days (p = .342) compared to the general anesthesia group. Following adjustment on multivariate analyses, the neuraxial anesthesia cohort no longer had increased likelihood of pulmonary complications or extended length of stay compared to the general anesthesia group. Healthy ankle fracture patients could also benefit from neuraxial anesthetic methods, and they should be considered for this anesthetic type regardless of their lack of comorbidities.

APA Citation

Quan, Theodore; Malyavko, Alisa; Ifarraguerri, Anna M.; Kim, Yumin; Mcdaniel, Lea; Manzi, Joseph E.; Agarwal, Amil R.; Chen, Frank R.; Gu, Alex; and Tabaie, Sean, "Evaluating the Association of Anesthesia Type With Postoperative Complications in Patients Undergoing Ankle Fracture Repair" (2022). GW Authored Works. Paper 208.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/208

Department

Pediatrics