Abstract
BACKGROUND: Anesthesia type for hip fracture surgery and its relation to postoperative delirium (POD) is a topic of ongoing debate. This study aimed to elucidate whether there is a significant difference in POD incidence, mortality, and length of hospital stay between general anesthesia (GA) and spinal anesthesia (SA). METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials that compared the outcomes of GA and SA in hip fracture surgeries, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data was extracted from 4 databases: PubMed, Embase, Web of Science, and the Cochrane Library. The main outcome of interest was the incidence of POD, with secondary outcomes including length of hospital stay and mortality rate. RESULTS: The initial database search yielded 1012 studies, 9 of which met inclusion criteria and were included in the meta-analysis. There was no significant difference in the incidence of POD at postoperative day 4 (RR = 1.03, 95% CI: 0.85-1.25, P > .05) or day 7 (RR = 1.05, 95% CI: 0.89-1.25, P > .05) between GA and SA groups. The mortality rate at 3 months post-surgery (RR = 1.02, 95% CI: 0.69-1.50, P > .05) and total hospital stay duration (MD = -0.04, 95% CI: -0.17 to 0.08, P > .05) also did not significantly differ between the 2 groups. CONCLUSION: Although SA has certain advantages over GA, no significant difference was observed in the incidence of postoperative delirium, mortality, and hospital stay length between the 2 methods.