Haemodynamic effects of continuous spinal anaesthesia versus single-shot spinal anaesthesia or general anaesthesia for hip fracture surgery: a systematic review and meta-analysis

Editor—In 2016, more than 70 000 patients aged ≥60 yr suffered hip fractures in the UK. 1 Veronese N. Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018; 49: 1458-1460 Google Scholar , 2 LeBlanc K. Muncie H. LeBlanc L. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician. 2014; 89: 945-951 Google Scholar , 3 Guzon-Illescas O. Perez Fernandez E. Crespí Villarias N. et al. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res. 2019; 14: 203 Google Scholar After hip fracture, 1-yr mortality is 20–40% and life expectancy is reduced by an average of 1.8 yr. 3 Guzon-Illescas O. Perez Fernandez E. Crespí Villarias N. et al. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res. 2019; 14: 203 Google Scholar ,4 Braithwaite R.S. Col N.F. Wong J.B. Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc. 2003; 51: 364-370 Google Scholar Hip fractures also impair activities of daily living and quality of life: in a 2003 study 26% of patients required support services at home and 12% moved to a nursing facility 1 yr after hip fracture. Only 30–40% of patients recover to their previous functional status. 4 Braithwaite R.S. Col N.F. Wong J.B. Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc. 2003; 51: 364-370 Google Scholar In 2019, the lifetime attributable costs were estimated at €50 000 in the USA. 5 Adeyemi A. Delhougne G. Incidence and economic burden of intertrochanteric fracture: a Medicare claims database analysis. JB JS Open Access. 2019; 4: e0045 Google Scholar Hence, hip fractures represent a significant burden for patients and healthcare systems.