Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study

Yeh, Han-Wei; Yeh, Liang-Tsai; Chou, Ying-Hsiang; Yang, Shun-Fa; Ho, Sai-Wai; Yeh, Ying-Tung; Yeh, Ying-Ting; Wang, Yu-Hsun; Chan, Chi-Ho; Yeh, Chao-Bin

doi:10.3390/ijerph17010033

Open AccessArticle

Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study

by

Han-Wei Yeh

^1,†,

Liang-Tsai Yeh

^2,3,†

,

Ying-Hsiang Chou

^2,4,5

,

Shun-Fa Yang

^2,6

,

Sai-Wai Ho

^7,8,

Ying-Tung Yeh

^9,10,

Ying-Ting Yeh

^9,10,

Yu-Hsun Wang

⁶,

Chi-Ho Chan

^6,11,* and

Chao-Bin Yeh

^7,8,*

¹

School of Medicine, Chang Gung University, Taoyuan City 333, Taiwan

²

Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan

³

Department of Anesthesiology, Changhua Christian Hospital, Changhua 500, Taiwan

⁴

Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung 402, Taiwan

⁵

Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung 402, Taiwan

⁶

Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan

⁷

Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan

⁸

Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan

⁹

School of Dentistry, Chung Shan Medical University, Taichung 402, Taiwan

¹⁰

Department of Dentistry, Chung Shan Medical University Hospital, Taichung 402, Taiwan

¹¹

Department of Microbiology and Immunology, Chung Shan Medical University, Taichung 402, Taiwan

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^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to the work.

Int. J. Environ. Res. Public Health 2020, 17(1), 33; https://doi.org/10.3390/ijerph17010033

Submission received: 26 September 2019 / Revised: 16 December 2019 / Accepted: 16 December 2019 / Published: 18 December 2019

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Abstract

The purpose of this study was to analyze the relationship between elevated cardiovascular disease (CVD) risk and type of anesthesia by using the National Health Insurance Research Database (NHIRD) of Taiwan in a one-year follow-up period. We assessed whether general anesthesia (GA) or neuraxial anesthesia (NA) increased CVD occurrence in lower-limb fracture patients. Approximately 1 million patients were randomly sampled from the NHIRD registry. We identified and enrolled 3437 lower-limb fracture patients who had received anesthesia during operations conducted in the period from 2010 to 2012. Next, patients were divided into two groups, namely GA (n = 1504) and NA (n = 1933), based on the anesthetic technique received during surgery. Our results revealed that those receiving GA did not differ in their risk of CVD relative to those receiving NA, adjusted HR = 1.24 (95% CI: 0.80–1.92). Patients who received GA for more than 2 h also did not differ in their risk of CVD relative to those receiving NA for less than 2 h, adjusted HR = 1.43 (95% CI: 0.81–2.50). Moreover, in the GA group (i.e., patients aged ≥65 years and women), no significant difference for the risk of CVD events was observed. In conclusion, in our study, the difference in the risk of CVD between lower-limb fracture patients receiving NA and GA was not statistically significant. The incidence rate of CVD seemed to be more correlated with patients’ underlying characteristics such as old age, comorbidities, or admission to the intensive care unit. Due to the limited sample size in this study, a database which reviews a whole national population will be required to verify our results in the future.

Keywords: cardiovascular diseases; general anesthesia; neuraxial anesthesia

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MDPI and ACS Style

Yeh, H.-W.; Yeh, L.-T.; Chou, Y.-H.; Yang, S.-F.; Ho, S.-W.; Yeh, Y.-T.; Yeh, Y.-T.; Wang, Y.-H.; Chan, C.-H.; Yeh, C.-B. Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 33. https://doi.org/10.3390/ijerph17010033

AMA Style

Yeh H-W, Yeh L-T, Chou Y-H, Yang S-F, Ho S-W, Yeh Y-T, Yeh Y-T, Wang Y-H, Chan C-H, Yeh C-B. Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study. International Journal of Environmental Research and Public Health. 2020; 17(1):33. https://doi.org/10.3390/ijerph17010033

Chicago/Turabian Style

Yeh, Han-Wei, Liang-Tsai Yeh, Ying-Hsiang Chou, Shun-Fa Yang, Sai-Wai Ho, Ying-Tung Yeh, Ying-Ting Yeh, Yu-Hsun Wang, Chi-Ho Chan, and Chao-Bin Yeh. 2020. "Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study" International Journal of Environmental Research and Public Health 17, no. 1: 33. https://doi.org/10.3390/ijerph17010033

APA Style

Yeh, H.-W., Yeh, L.-T., Chou, Y.-H., Yang, S.-F., Ho, S.-W., Yeh, Y.-T., Yeh, Y.-T., Wang, Y.-H., Chan, C.-H., & Yeh, C.-B. (2020). Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study. International Journal of Environmental Research and Public Health, 17(1), 33. https://doi.org/10.3390/ijerph17010033

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Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study

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