Anesthetic Care for Orthopedic Patients: Is There a Potential for Differences in Care?

Anesthesiology
Stavros G MemtsoudisMadhu Mazumdar

Abstract

Differences in health care represent a major health policy issue. Despite increasing evidence on the mediating role of anesthesia type used for surgery on perioperative outcome, there is a lack of data on potential care differences in this field. The authors aimed to determine whether anesthesia practice (use of neuraxial anesthesia [NA] or peripheral nerve block [PNB]) differs by patient and hospital factors. The authors extracted data on n = 1,062,152 hip and knee arthroplasty procedures from the Premier Perspective database (2006 to 2013). Multilevel multivariable logistic regression models measured associations (odds ratios [ORs] and 95% CIs) between patient/hospital factors and NA or PNB use. Of all patients, 22.2% (n = 236,083) received NA and 17.9% (n = 189,732) received PNB. Lower adjusted odds for receiving NA were seen for black patients (OR, 0.88; 95% CI, 0.86 to 0.91) and those on Medicaid (OR, 0.78; 95% CI, 0.74 to 0.82) or without insurance (OR, 0.89; 95% CI, 0.81 to 0.98). Furthermore, teaching hospitals (compared with nonteaching hospitals) had lower adjusted odds for NA utilization (OR, 0.35; 95% CI, 0.14 to 0.89). Although generally similar patterns were seen for PNB utilization, the main difference was that p...Continue Reading

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Citations

May 16, 2017·Paediatric Anaesthesia·Olubukola O NafiuPaul I Reynolds
Sep 12, 2017·Pain·Crispiana CozowiczStavros G Memtsoudis
Aug 11, 2018·European Journal of Anaesthesiology·Alexander SchnabelChristine H Meyer-Frießem
Jun 24, 2019·Regional Anesthesia and Pain Medicine·Stavros Memtsoudis, Ottokar Stundner
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Mar 28, 2020·Journal of Comparative Effectiveness Research·Rohan JotwaniRobert S White
Aug 2, 2017·European Journal of Anaesthesiology·Alexander SchnabelChristine H Meyer-Frießem
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Jan 12, 2021·Anaesthesia·D F Johnston, L R Turbitt
Jan 1, 2021·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Kathryn DelPizzoStavros G Memtsoudis
Feb 26, 2021·Current Opinion in Anaesthesiology·Odinakachukwu EhieAlexandra Bastien
Apr 1, 2021·Journal of Comparative Effectiveness Research·Briana LuiRobert S White
Jun 5, 2021·The Journal of Surgical Research·Jennie MeierCourtney J Balentine
Jun 6, 2021·Mayo Clinic Proceedings·Natalie H StrandAmy C S Pearson
Jun 20, 2017·Journal of Clinical Anesthesia·Robert B SchonbergerMatthew M Burg

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