MAC-STILA

1 Demographics

Table 1: Baseline demographics

Characteristic	Group		p-value2
	MAC-STILA, N = 791	General Anesthesia, N = 1581
Age	82.9 +/- 10.5	82.6 +/- 10.6	0.797
Sex			0.925
Male	30 (38.0%)	61 (38.6%)
Female	49 (62.0%)	97 (61.4%)
BMI	24.5 +/- 4.9	24.3 +/- 5.2	0.802
ASA			0.242
0	2 (2.5%)	0 (0.0%)
2	9 (11.4%)	19 (12.0%)
3	51 (64.6%)	111 (70.3%)
4	17 (21.5%)	28 (17.7%)
Marital Status			<0.001
Single	22 (27.8%)	44 (28.8%)
Married	18 (22.8%)	51 (33.3%)
Divorced	23 (29.1%)	9 (5.9%)
Widowed	16 (20.3%)	49 (32.0%)
CCI	1.6 +/- 1.6	2.1 +/- 1.9	0.025
Independent at Baseline	42 (53.2%)	100 (63.3%)	0.134
Baseline Dementia	24 (30.4%)	34 (21.5%)	0.135
Pre-Injury Ambulatory Status			0.923
Community	51 (64.6%)	103 (65.2%)
Household	28 (35.4%)	55 (34.8%)
Pre-Injury Use of Assistive Device	60 (75.9%)	125 (79.1%)	0.579
Fracture Pattern			0.889
31A	69 (87.3%)	139 (88.0%)
31B	10 (12.7%)	19 (12.0%)
Implant			0.902
CRPP	7 (8.9%)	12 (7.6%)
Short CMN	66 (83.5%)	132 (83.5%)
Long CMN	6 (7.6%)	14 (8.9%)
1 Mean +/- SD; n (%)
2 Welch Two Sample t-test; Pearson’s Chi-squared test; Fisher’s Exact Test for Count Data with simulated p-value (based on 2000 replicates)

2 Intraoperative Vitals

Table 2: Intraoperative vitals and labs

Characteristic	Group		p-value2
	MAC-STILA, N = 791	General Anesthesia, N = 1581
Respiratory rate (minimum)	8.8 +/- 4.5	4.4 +/- 2.9	<0.001
Respiratory rate (maximum)	29.4 +/- 6.6	24.2 +/- 7.0	<0.001
Systolic BP (minimum)	96.4 +/- 18.4	83.4 +/- 16.2	<0.001
Systolic BP (maximum)	160.9 +/- 24.6	163.3 +/- 25.8	0.486
Diastolic BP (minimum)	52.9 +/- 9.7	45.2 +/- 10.6	<0.001
Diastolic BP (maximum)	93.2 +/- 13.5	96.0 +/- 20.4	0.202
HR (minimum)	60.8 +/- 8.9	63.4 +/- 13.1	0.079
HR (maximum)	107.8 +/- 21.2	168.8 +/- 834.6	0.361
Postoperative hemoglobin	9.2 +/- 2.0	9.3 +/- 2.4	0.871
Preoperative hemoglobin	11.3 +/- 1.8	11.4 +/- 1.9	0.744
ETCO2 (mean)	22.7 +/- 5.7	29.9 +/- 6.0	<0.001
ETCO2 (minimum)	3.5 +/- 5.4	5.0 +/- 10.4	0.158
ETCO2 (maximum)	34.9 +/- 9.7	42.1 +/- 7.6	<0.001
1 Mean +/- SD
2 Welch Two Sample t-test

3 VAS Pain Scores

Table 3: Pain

Characteristic	Group		p-value2
	MAC-STILA, N = 791	General Anesthesia, N = 1581
8 hours	1.7 +/- 2.6	1.8 +/- 3.1	0.954
16 hours	3.2 +/- 3.4	4.0 +/- 3.4	0.209
24 hours	3.5 +/- 3.7	4.3 +/- 3.3	0.168
48 hours	3.9 +/- 3.6	4.4 +/- 3.1	0.398
1 Mean +/- SD
2 Welch Two Sample t-test

4 Complications

Table 4: Complications and Mortality

Characteristic	Group		p-value2
	MAC-STILA, N = 791	General Anesthesia, N = 1581
Major complication	9 (11.4%)	16 (10.1%)	0.765
Minor complication	28 (35.4%)	80 (50.6%)	0.027
Hypotension	6 (7.6%)	16 (10.1%)	0.527
Shock	3 (3.8%)	3 (1.9%)	0.403
Pneumonia	6 (7.6%)	7 (4.4%)	0.367
DVT	1 (1.3%)	1 (0.6%)	>0.999
COPD exacerbation	2 (2.5%)	2 (1.3%)	0.602
MI	1 (1.3%)	1 (0.6%)	>0.999
AKI	7 (8.9%)	20 (12.7%)	0.386
CVA	1 (1.3%)	2 (1.3%)	>0.999
Surgical site infection	3 (3.8%)	0 (0.0%)	0.036
Decubitus ulcer	1 (1.3%)	5 (3.2%)	0.667
UTI	8 (10.1%)	11 (7.0%)	0.398
Respiratory failure	6 (7.6%)	7 (4.4%)	0.367
Anemia	33 (41.8%)	59 (37.3%)	0.509
Cardiac arrest	0 (0.0%)	3 (1.9%)	0.553
Death during admission	1 (1.3%)	4 (2.5%)	0.667
death_48h	0 (0.0%)	1 (0.6%)	>0.999
30-day mortality	8 (10.1%)	4 (2.5%)	0.023
90-day mortality	8 (10.1%)	6 (3.8%)	0.076
Readmission within 30 days	10 (12.7%)	14 (8.9%)	0.361
Reoperation	4 (5.1%)	4 (2.5%)	0.445
1 n (%)
2 Pearson’s Chi-squared test; Fisher’s exact test

5 Ambulation

Table 5: Ambulatory status by day

Characteristic	Group		p-value2
	MAC-STILA, N = 791	General Anesthesia, N = 1581
Ambulated on POD1	37 (46.8%)	75 (48.1%)	0.857
Ambulated on POD2	53 (67.1%)	101 (63.9%)	0.630
Ambulated on POD3	54 (68.4%)	115 (72.8%)	0.477
Ambulated before discharge	60 (75.9%)	125 (79.1%)	0.579
Distance ambulated before discharge (feet)	20.6 +/- 27.8	27.2 +/- 43.8	0.228
Maximum distance ambulated (feet)	15.8 +/- 25.0	23.4 +/- 40.6	0.077
1 n (%); Mean +/- SD
2 Pearson’s Chi-squared test; Welch Two Sample t-test

6 GLM: Ambulation by discharge

Table 6: Odds of ambulating by time of discharge

Characteristic	OR1	95% CI1	p-value
Group
General Anesthesia	—	—
MAC-STILA	0.91	0.44, 1.89	0.788
ASA	0.71	0.40, 1.22	0.227
Baseline ambulatory status
Community	—	—
Household	0.62	0.31, 1.25	0.181
Baseline assistive device
No	—	—
Yes	0.15	0.02, 0.55	0.014
Preoperative dementia	0.19	0.09, 0.39	<0.001
1 OR = Odds Ratio, CI = Confidence Interval

Table: Multivariable logistic regression demonstrating that there is no difference in the odds of being able to ambulate by the time of discharge between groups.

7 GLM: Odds of AMS postoperatively

Table 7: Odds of developing postoperative AMS

Characteristic	OR1	95% CI1	p-value
Group
General Anesthesia	—	—
MAC-STILA	0.10	0.02, 0.40	0.003
ASA	1.53	0.71, 3.29	0.267
CCI	0.85	0.63, 1.13	0.272
Baseline ambulatory status
Community	—	—
Household	2.64	0.98, 7.39	0.057
Baseline assistive device
No	—	—
Yes	5.16	1.11, 35.0	0.058
Preoperative dementia	128	38.0, 627	<0.001
Intraoperative systolic BP (minimum)	1.00	0.97, 1.03	0.915
Intraoperative diastolic BP (minimum)	1.03	0.97, 1.09	0.346
Intraoperative ETCO2 (mean)	1.01	0.93, 1.10	0.749
1 OR = Odds Ratio, CI = Confidence Interval

Table: Multivariable logistic regression demonstrating that patients in the MAC-STILA group were associated with significantly lower odds of postoperative (POD0-3) AMS compared to patients in the general anesthesia group.

8 MME

Table 8: MME comparison

Characteristic	Group		p-value2
	MAC-STILA, N = 791	General, N = 1581
MME - 24 hours	16.4 +/- 12.1	20.4 +/- 13.6	0.027
MME - 48 hours	22.5 +/- 16.5	31.5 +/- 23.0	0.002
MME - Total hospitalization	43.0 +/- 41.3	63.1 +/- 75.9	0.055
1 Mean +/- SD
2 Wilcoxon rank sum test

Figure 1: MME