Long-Term Outcomes Associated With Peripheral Nerve Blocks for Hip Fracture Surgery: A Retrospective Comparison of Medicare Data

IF 4.5 2区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of the American Geriatrics Society Pub Date : 2026-04-14 Epub Date: 2026-02-15 DOI:10.1111/jgs.70340

Arissa M. Torrie, Nathan N. O'Hara, Kathleen A. Ryan, Tedric Henneghan, Vineesh Mathur, Robert V. O'Toole, Gerard P. Slobogean, Jason Falvey

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Abstract

Background

Peripheral nerve blocks (PNBs) are increasingly recommended as analgesia for hip fractures. Their association with outcomes beyond the immediate pharmacological effects remains unclear. This study examined the association between the use of PNBs and the number of days alive and at home after hip fracture surgery among Medicare beneficiaries.

Methods

To examine the association between PNBs and long-term outcomes in older adults undergoing surgical fixation for hip fractures, we analyzed Medicare data from 2010 to 2018. Patients who received PNBs (exposure group) (n = 5701) were compared to those who did not receive a PNB (comparator group) using 1:1 propensity score matching, creating 5700 matched pairs. The primary outcome was days alive and at home within 120 days of admission. Secondary outcomes included days alive and at home within 365 days and 1-year mortality. A subgroup analysis of propensity score matched patients from 2018 examined outcomes when techniques had improved and use had increased.

Results

In the primary analysis (2010–2018), no significant differences were observed between groups for days alive and at home within 120 days (68.1 vs. 68.4 days; p = 0.64), days alive and at home within 365 days (244.5 vs. 240.7 days; p = 0.12), or 1-year mortality (21% vs. 22%; p = 0.22). In 2017 and 2018, when peripheral nerve block use increased, patients who received PNBs spent more days alive and at home within 365 days than patients who did not receive peripheral nerve blocks (248.6 vs. 241.6 days; p = 0.04).

Conclusion

PNBs showed no association with improved outcomes across the 2010–2018 study period. Analysis of 2017 and 2018 revealed more days alive and at home within 365 days and a trend toward reduced mortality among patients who received PNBs. PNBs may provide benefits beyond their immediate analgesic effects, potentially improving long-term outcomes.

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查看原文本刊更多论文

髋部骨折手术与周围神经阻滞相关的长期结果：医疗保险数据的回顾性比较。

背景：周围神经阻滞（PNBs）被越来越多地推荐用于髋部骨折的镇痛。它们与直接药理作用之外的结果的关系尚不清楚。本研究调查了医疗保险受益人髋部骨折手术后使用pnb与存活和在家天数之间的关系。方法：为了研究接受髋部骨折手术固定的老年人pnb与长期预后之间的关系，我们分析了2010年至2018年的Medicare数据。接受PNB的患者（暴露组）（n = 5701）与未接受PNB的患者（比较组）使用1:1的倾向评分匹配，创建5700对匹配对。主要预后指标为入院120天内存活和在家的天数。次要结局包括365天内在家存活天数和1年死亡率。对2018年倾向评分匹配患者的亚组分析检查了技术改进和使用增加时的结果。结果：在初步分析（2010-2018）中，两组患者120天内的存活天数和在家的天数（68.1天vs. 68.4天，p = 0.64）、365天内的存活天数和在家的天数（244.5天vs. 240.7天，p = 0.12）或1年死亡率（21% vs. 22%, p = 0.22）均无显著差异。2017年和2018年，当周围神经阻滞的使用增加时，接受pnb的患者在365天内比未接受周围神经阻滞的患者生活和在家的天数更多（248.6天vs 241.6天；p = 0.04）。结论：在2010-2018年的研究期间，pnb与改善的结果没有关联。2017年和2018年的分析显示，接受pnb治疗的患者在365天内存活和在家的天数更多，死亡率呈下降趋势。pnb提供的益处可能超出其即时镇痛效果，可能改善长期疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Geriatrics Society 医学-老年医学

CiteScore

10.00

自引率

6.30%

发文量

504

审稿时长

3-6 weeks

期刊介绍： Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.