Association of Peripheral Nerve Blocks with Postoperative Outcomes and Readmissions in Older Adults Undergoing Hip Fracture Surgery

PROJECT SUMMARY Hip fractures in older adults represent a critical healthcare challenge, with one-year mortality rates exceeding 20% despite advancements in surgical and anesthesia techniques. The choice of anesthesia for hip fracture surgery may significantly influence postoperative outcomes and complication risks, but the extent and nature of this association remain unclear. Traditionally, general and neuraxial anesthesia have been the primary approaches for hip fracture surgeries. However, recent studies comparing the effectiveness of these methods have yielded mixed results. As the debate continues, peripheral nerve blocks (PNBs) have emerged as a promising adjunct to these traditional anesthetic techniques. PNBs have shown benefits in reducing pain and opioid consumption, with some studies suggesting they may also lower morbidity and mortality rates. Despite these promising findings, robust evidence on the long-term benefits of PNBs in hip fracture patients beyond acute pain management is still lacking. The objective of this proposal is to evaluate the association of peripheral nerve blocks (PNBs) on postoperative outcomes in older adults undergoing hip fracture surgery. This will be accomplished through the following aims: 1) Evaluate the association between peripheral nerve block use and in-hospital postoperative outcomes in older adults undergoing hip fracture surgery; 2) Evaluate the impact of peripheral nerve block use on 90-day hospital readmission rates among older adults following hip fracture surgery; and 3) Identify the differential effects of peripheral nerve block on postoperative outcomes across specific subgroups of older adults undergoing hip fracture surgery. Leveraging the Premier Healthcare Database, which captures 20-25% of annual U.S. inpatient discharges, we will conduct a large-scale retrospective cohort study focusing on patients aged 65 and older who underwent surgical management of hip fractures. Statistical techniques to minimize selection bias, such as propensity score matching, will be used to analyze a composite outcome of myocardial infarction, stroke, and all-cause mortality, as well as hospital readmission rates. By addressing critical knowledge gaps in the field, this study aims to provide further evidence on the potential benefits of PNBs in hip fracture surgery for older adults.