{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:02:50Z","timestamp":1792065770837,"version":"4.4.0"},"reference-count":37,"publisher":"BMJ","issue":"9","funder":[{"name":"Ministry of Education of Korea","award":["NRF-2017R1D1A3B03034298"],"award-info":[{"award-number":["NRF-2017R1D1A3B03034298"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,9]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of anaesthesia on postoperative outcome in elderly patients who underwent hip fracture surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Nationwide National Health Insurance Sharing Service database of Korea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All patients aged \u226565 years old who underwent hip fracture surgery, covered by the Korean National Health Insurance, between 1 January 2009 and 31 December 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Hip fracture surgery under general anaesthesia (group GA) or regional anaesthesia (group RA), with a principal diagnosis of femoral fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was the anaesthetic-type effect on 30-day mortality and the secondary outcome was postoperative delirium requiring pharmacological intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 96\u2009289 patients who underwent hip fracture surgery, 25\u2009593 and 70\u2009696 patients received GA and RA, respectively. After propensity score matching, 25\u2009593 remained in each group. Postmatching mortality was lower in the RA than in the GA group (574 (2.24%) vs 654 (2.55%), p=0\u00b70047, 95% CI \u22120.0099 to 0.0159). Delirium incidence was lower in the RA than in the GA group (5187 (20.27%) vs 5828 (22.77%), p&lt;0\u00b70001, 95%\u2009CI 0.019 to 0.045). The incidence of intensive care unit stay and ventilator care was lower in the RA than in the GA group (5838 (22.1%) vs 8055 (31.47%), p&lt;0\u00b70001, 95%\u2009CI 0.046 to 0.070 and 459 (1.73%) vs 1207 (4.72%), p&lt;0\u00b70001, 95%\u2009CI \u22120.0024 to 0.023, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RA was associated with better outcomes than GA, in terms of mortality, delirium, intensive care unit admission and ventilator care, in elderly patients who underwent hip fracture surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029245","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T16:25:19Z","timestamp":1568046319000},"page":"e029245","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":100,"title":["Comparison of general anaesthesia and regional anaesthesia in terms of mortality and complications in elderly patients with hip fracture: a nationwide population-based study"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"isrctn1565914","registry":"10.18810\/isrctn"}],"author":[{"given":"Eun Jin","family":"Ahn","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hey Ran","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine and Graduate School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-0199","authenticated-orcid":false,"given":"Si Ra","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,9]]},"reference":[{"key":"2025121410070016000_9.9.e029245.1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2015.30.4.483"},{"key":"2025121410070016000_9.9.e029245.2","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1007\/s00198-016-3576-9","article-title":"Current trends and future projections of hip fracture in South Korea using nationwide claims data","volume":"27","author":"YC","year":"2016","journal-title":"Osteoporos Int"},{"key":"2025121410070016000_9.9.e029245.3","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000695"},{"key":"2025121410070016000_9.9.e029245.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60688-1"},{"key":"2025121410070016000_9.9.e029245.5","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13106"},{"key":"2025121410070016000_9.9.e029245.6","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-014-3686-7"},{"key":"2025121410070016000_9.9.e029245.7","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1302\/0301-620X.97B5.35042","article-title":"General versus spinal anaesthesia for patients aged 70 years and older with a fracture of the hip","volume":"97-B","author":"Basques","year":"2015","journal-title":"Bone Joint J"},{"key":"2025121410070016000_9.9.e029245.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.6499"},{"key":"2025121410070016000_9.9.e029245.9","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200004000-00011"},{"key":"2025121410070016000_9.9.e029245.10","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12542"},{"key":"2025121410070016000_9.9.e029245.11","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3109\/17453674.2015.1128781","article-title":"Similar mortality with general or regional anesthesia in elderly hip fracture patients","volume":"87","author":"Brox","year":"2016","journal-title":"Acta Orthop"},{"key":"2025121410070016000_9.9.e029245.12","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000003296","article-title":"The effect of anesthetic type on outcomes of hip fracture surgery: a nationwide population-based study","volume":"95","author":"Tung","year":"2016","journal-title":"Medicine"},{"key":"2025121410070016000_9.9.e029245.13","doi-asserted-by":"crossref","first-page":"S67","DOI":"10.3233\/JAD-2010-101086","article-title":"The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis","volume":"22","author":"Mason","year":"2010","journal-title":"J Alzheimers Dis"},{"key":"2025121410070016000_9.9.e029245.14","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.84850"},{"key":"2025121410070016000_9.9.e029245.15","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-020757","article-title":"Effect of regional versus general anaesthesia on postoperative delirium in elderly patients undergoing surgery for hip fracture: a systematic review","volume":"8","author":"Patel","year":"2018","journal-title":"BMJ Open"},{"key":"2025121410070016000_9.9.e029245.16","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e318252e901"},{"key":"2025121410070016000_9.9.e029245.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.05.004"},{"key":"2025121410070016000_9.9.e029245.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-016937","article-title":"Comparison of regional with general anaesthesia on postoperative delirium (RAGA-delirium) in the older patients undergoing hip fracture surgery: study protocol for a multicentre randomised controlled trial","volume":"7","author":"Li","year":"2017","journal-title":"BMJ Open"},{"key":"2025121410070016000_9.9.e029245.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013473","article-title":"Regional versus general anesthesia for promoting independence after hip fracture (REGAIN): protocol for a pragmatic, international multicentre trial","volume":"6","author":"Neuman","year":"2016","journal-title":"BMJ Open"},{"key":"2025121410070016000_9.9.e029245.20","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-023609","article-title":"Improve hip fracture outcome in the elderly patient (iHOPE): a study protocol for a pragmatic, multicentre randomised controlled trial to test the efficacy of spinal versus general anaesthesia","volume":"8","author":"Kowark","year":"2018","journal-title":"BMJ Open"},{"key":"2025121410070016000_9.9.e029245.21","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s40520-016-0541-6","article-title":"Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis","volume":"29","author":"Yang","year":"2017","journal-title":"Aging Clin Exp Res"},{"key":"2025121410070016000_9.9.e029245.22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.14.1753"},{"key":"2025121410070016000_9.9.e029245.23","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000145587.16421.BB"},{"key":"2025121410070016000_9.9.e029245.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.11.016"},{"key":"2025121410070016000_9.9.e029245.25","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S0034-7094(12)70146-0","article-title":"Postoperative delirium in intensive care patients: risk factors and outcome","volume":"62","author":"Veiga","year":"2012","journal-title":"Rev Bras Anestesiol"},{"key":"2025121410070016000_9.9.e029245.26","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1002\/gps.4655","article-title":"Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis","volume":"32","author":"Smith","year":"2017","journal-title":"Int J Geriatr Psychiatry"},{"key":"2025121410070016000_9.9.e029245.27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53120.x"},{"key":"2025121410070016000_9.9.e029245.28","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s40140-018-0282-5","article-title":"An update on postoperative delirium: clinical features, neuropathogenesis, and perioperative management","volume":"8","author":"Safavynia","year":"2018","journal-title":"Curr Anesthesiol Rep"},{"key":"2025121410070016000_9.9.e029245.29","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H241"},{"key":"2025121410070016000_9.9.e029245.30","doi-asserted-by":"crossref","DOI":"10.1186\/1471-244X-13-240","article-title":"Efficacy and safety of haloperidol versus atypical antipsychotic medications in the treatment of delirium","volume":"13","author":"Yoon","year":"2013","journal-title":"BMC Psychiatry"},{"key":"2025121410070016000_9.9.e029245.31","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.156.1.1"},{"key":"2025121410070016000_9.9.e029245.32","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2009.24"},{"key":"2025121410070016000_9.9.e029245.33","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/28.2.115"},{"key":"2025121410070016000_9.9.e029245.34","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.arth.2017.09.003","article-title":"Big data and total hip arthroplasty: how do large databases compare?","volume":"33","author":"Bedard","year":"2018","journal-title":"J Arthroplasty"},{"key":"2025121410070016000_9.9.e029245.35","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"2025121410070016000_9.9.e029245.36","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1016\/j.injury.2015.10.025","article-title":"Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review","volume":"46","author":"Marufu","year":"2015","journal-title":"Injury"},{"key":"2025121410070016000_9.9.e029245.37","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-029245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T18:07:09Z","timestamp":1765735629000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-029245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":37,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,9]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bmjopen-2019-029245"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-029245","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}