Variations in Anesthesia Care for Hip Fracture Surgery

NCT02787031 | Completed Results

• 1 other identifier: DM2
• Study Type: observational
• Target: 107,317
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators will use health administrative data to examine the variation of anesthesia type for hip fracture surgery, as well as sources of variation and predictors of variation.

Conditions

Hip Fractures; Anesthesia; Death

Keywords

hip fracture; geriatric; epidemiology; practice variation; anesthesia

Outcome Measures

Primary Outcomes (1)

• Number of Participants With All-Cause Mortality at 30-days

  Day of surgery to day of death, or up to 30 days, whichever comes first

Secondary Outcomes (1)

• Healthcare Costs From the Perspective of the Universal Healthcare System, Using Standardized Methods (Health System Performance Research Network 2013)

  Day of surgery to day of death, or 30 days after surgery, whichever comes first

Other Outcomes (1)

• Hospital Length of Stay

  Day of surgery to day of discharge, or up to 365 days, whichever comes first

Study Arms (2)

Neuraxial anesthesia

Participants in this group will be those who had a spinal or epidural anesthetic without concurrent general anesthesia

Procedure: Neuraxial anesthesia

General anesthesia

Participants in this group will be those who had general anesthesia, including those who had a general plus a concurrent spinal or epidural anesthetic.

Procedure: General anesthesia

Interventions

Neuraxial anesthesia PROCEDURE

Also known as: spinal anesthesia, epidural anesthesia

Neuraxial anesthesia

General anesthesia PROCEDURE

General anesthesia

Eligibility Criteria

• Age: 66 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All Ontario residents aged 66 years or older on the day of their emergency hip fracture surgery.

You may qualify if:

• Had hip fracture surgery
• Admitted to hospital on a non-elective basis

You may not qualify if:

• Do not hold a valid provincial health insurance account

Sponsors & Collaborators

• Ottawa Hospital Research Institute: lead

Study Sites (1)

Ottawa Hospital Research Institute

Ottawa, Ontario, K1Y4E9, Canada

Location

Related Publications (1)

• McIsaac DI, Wijeysundera DN, Bryson GL, Huang A, McCartney CJL, van Walraven C. Hospital-, Anesthesiologist-, and Patient-level Variation in Primary Anesthesia Type for Hip Fracture Surgery: A Population-based Cross-sectional Analysis. Anesthesiology. 2018 Dec;129(6):1121-1131. doi: 10.1097/ALN.0000000000002453.

  PMID: 30273269 DERIVED

MeSH Terms

Conditions

Hip Fractures; Death

Interventions

Anesthesia, Spinal; Anesthesia, Epidural; Anesthesia, General

Condition Hierarchy (Ancestors)

Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia

Limitations and Caveats

Health administrative data are not initially collected for research purposes. There are patient-level predictors, hospital-level variables, and anesthesiologist variables that we could not measure directly. Surgeon-specific variables such as preference for neuraxial versus general anesthesia could influence anesthesia decision making and should be considered. Patient-preference should contribute to warranted variation. The generalizability of our findings to other jurisdictions is uncertain.

Results Point of Contact

• Title: Dr. Daniel McIsaac
• Organization: The Ottawa Hospital

dmcisaac@toh.ca

613-761-4940

Study Officials

• Daniel McIsaac, MD,MPH,FRCPC

  The Ottawa Hospital

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 17, 2016
• First Posted: June 1, 2016
• Study Start: April 1, 2002
• Primary Completion: March 1, 2013
• Study Completion: May 1, 2016
• Last Updated: March 17, 2025
• Results First Posted: March 17, 2025

Record last verified: 2025-02

Locations

CA (1)