Aging population are fast growing especially in developed country. South Korea is one of the rapid changing society of elderly population which represents as aged society that defined as an elderly population is more than14%  of the total population. Ha et al. reported that hip fracture incidence continues to increase, and the predicted increases will be a serious socioeconomic burden and a challenge for public health care managements in Korea.  Hip fracture is usually associated with adverse complications including mortality that resulted medical and financial burden for the society.
One of the most common and adverse complication of elderly hip fracture patients is delirium. It is associated increased rate of cognitive decline, institutionalization, and mortality. 
To decrease the mortality rate and postoperative delirium one of recommendation is choice of anesthesia method. Mode of anesthesia related mortality and outcome in geriatric patients are debated questions. There are some reports that most of the anesthesia related complication are multifactorial. However, in hip fracture surgery there are some reports that RA represents favorable outcome. We used nationwide database to evaluate the effects of anesthesia on postoperative outcome 
The primary outcome of this study was to evaluate the anesthetic method affect 30 day in hospital mortality in hip fracture surgery using nationwide database. Furthermore, we compared postoperative delirium which needed pharmacological intervention between general anesthesia and regional anesthesia.

Cohort/Group Label

patients undergoing hip fracture surgery aged older than 65 years under general anesthesia

Cohort/Group Description

all patients undergoing hip fracture surgery aged 65 years and older admitted to hospitals in Korea . The major inclusion criterion was admission with a principal diagnosis of femur neck fracture(S720) and trochanteric fracture(S721) as identified through the patient’s principal diagnosis recorded using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code. We included those admissions who underwent at least one of the following surgical operations based on ICD-10-CM procedure codes: N0601, N0611, N0711, N2070, N0715, N2710, N1715, N4710, N1725, N4720. We included who received general anesthesia.

Cohort/Group Label

patients undergoing hip fracture surgery aged older than 65 years under regional anesthesia

Cohort/Group Description

all patients undergoing hip fracture surgery aged 65 years and older admitted to hospitals in Korea . The major inclusion criterion was admission with a principal diagnosis of femur neck fracture(S720) and trochanteric fracture(S721) as identified through the patient’s principal diagnosis recorded using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code. We included those admissions who underwent at least one of the following surgical operations based on ICD-10-CM procedure codes: N0601, N0611, N0711, N2070, N0715, N2710, N1715, N4710, N1725, N4720. We included who received regional(spinal and epidural) anesthesia.

Not collect nor Archive

patients undergoing hip fracture surgery aged 65 years and older admitted to hospitals in Korea using national health insurance claims data

principal diagnosis of femur neck fracture(S72.0) and trochanteric fracture(S72.1) as identified through the patient’s principal diagnosis recorded using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code. We included those admissions who underwent at least one of the following surgical operations based on ICD-10-CM procedure codes: N0601, N0611, N0711, N2070, N0715, N2710, N1715, N4710, N1725, N4720.

Gender

Age

Description

principal diagnosis of femur neck fracture(S72.0) and trochanteric fracture(S72.1) as identified through the patient’s principal diagnosis recorded using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code. We included those admissions who underwent at least one of the following surgical operations based on ICD-10-CM procedure codes: N0601, N0611, N0711, N2070, N0715, N2710, N1715, N4710, N1725, N4720. We included who received general, spinal and epidural anesthesia.

We excluded patients who received both general and regional anesthesia. For patients with diagnosis of multiple trauma or fracture ('S00-S70', 'S73-99', 'T07', 'T14') were excluded. Also, we excluded patients who underwent more than twice of the operations during the same period of admission.

Thirty-day mortality

postoperative 30 days

occurrence of delirium

at least once during the indexed administration period