학술논문
Impact of Neuraxial Versus General Anesthesia on Discharge Destination in Patients Undergoing Primary Total Hip and Total Knee Replacement.
Document Type
Academic Journal
Author
Duque M; From the Departments of Anesthesiology and Perioperative Medicine.; Schnetz MP; From the Departments of Anesthesiology and Perioperative Medicine.; Yates AJ Jr; Orthopaedic Surgery.; Monahan A; From the Departments of Anesthesiology and Perioperative Medicine.; Whitehurst S; From the Departments of Anesthesiology and Perioperative Medicine.; Mahajan A; From the Departments of Anesthesiology and Perioperative Medicine.; Kaynar AM; From the Departments of Anesthesiology and Perioperative Medicine.; Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Source
Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Total knee replacement (TKR) and total hip replacement (THR) are 2 of the most common orthopedic surgical procedures in the United States. These procedures, with fairly low mortality rates, incur significant health care costs, with almost 40% of the costs associated with post acute care. We assessed the impact of general versus neuraxial anesthesia on discharge destination and 30-day readmissions in patients who underwent total knee and hip replacement in our health system.
Methods: This was a retrospective cohort study of 24,684 patients undergoing total knee or hip replacement in 13 hospitals of a large health care network. Following propensity score matching, we studied the impact of type of anesthetic technique on discharge destination (primary outcome) and postoperative complications including readmissions in 8613 patients who underwent THR and 13,004 patients for TKR.
Results: Our results showed that in patients undergoing THR and TKR, neuraxial anesthesia is associated with higher odds of being discharged from hospital to home versus other facilities compared to general anesthesia (odds ratio [OR] = 1.63, 95% confidence interval [CI], 1.52-1.76; P < .01) and (OR = 1.58, 95% CI, 1.49-1.67; P < .01), respectively.
Conclusions: Our results suggest an association between use of neuraxial anesthesia for total joint arthroplasty and a higher probability of discharge to home and a reduction in readmissions.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2020 International Anesthesia Research Society.)
Methods: This was a retrospective cohort study of 24,684 patients undergoing total knee or hip replacement in 13 hospitals of a large health care network. Following propensity score matching, we studied the impact of type of anesthetic technique on discharge destination (primary outcome) and postoperative complications including readmissions in 8613 patients who underwent THR and 13,004 patients for TKR.
Results: Our results showed that in patients undergoing THR and TKR, neuraxial anesthesia is associated with higher odds of being discharged from hospital to home versus other facilities compared to general anesthesia (odds ratio [OR] = 1.63, 95% confidence interval [CI], 1.52-1.76; P < .01) and (OR = 1.58, 95% CI, 1.49-1.67; P < .01), respectively.
Conclusions: Our results suggest an association between use of neuraxial anesthesia for total joint arthroplasty and a higher probability of discharge to home and a reduction in readmissions.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2020 International Anesthesia Research Society.)