Hypothesis: To evaluate whether spinal anesthesia is associated with a reduction in 30-day mortality after elective THA or TKA compared to general anesthesia.
Methods: Greater than 10,000 patients receiving spinal anesthesia or general anesthesia for lower extremity total joint arthroplasties at a single center were analyzed for the primary outcome of 30-day mortality. Propensity score matching was used to compare 2,135 patients in each group.
Results: The risk of death in the spinal anesthesia group was lower (RR 0.42) vs the general anesthesia group.
Strengths: Used propensity score matching, well-powered
Weaknesses: Single-center study, unknown causes of death, questionable completeness of patient comorbidity data
Key Point: The use of spinal anesthesia for TKAs and THAs may be associated with a lower risk of death.