Regional anesthesia decreases complications and resource utilization in shoulder arthroplasty patients
| Autor: | Haiyin Liu, Matthew M. Davis, Brian D. Sites, Michael D. Herrick, J.-E. Bell |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_treatment Anesthesia General Logistic regression law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine Anesthesia Conduction 030202 anesthesiology law medicine Humans 030212 general & internal medicine Aged Aged 80 and over business.industry General Medicine Perioperative Length of Stay Middle Aged Intensive care unit Arthroplasty Logistic Models Anesthesiology and Pain Medicine Arthroplasty Replacement Shoulder Anesthesia Anesthetic Nerve block Health Resources Female business Complication Resource utilization medicine.drug |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 62:540-547 |
| ISSN: | 0001-5172 |
| DOI: | 10.1111/aas.13063 |
| Popis: | Background Regional anesthesia can be used as part of the anesthetic to optimize anesthesia and analgesia during shoulder arthroplasty, but little is known about the overall effect that regional anesthesia has on perioperative outcomes and resource utilization. We hypothesized that regional anesthesia may decrease complication rates and resource utilization in shoulder arthroplasty patients. Methods We examined administrative data from 588 US hospitals from 2010 to 2015. Logistic regression was used to examine the relationship between type of anesthesia and perioperative complications. Results Among patients who underwent shoulder arthroplasty, 79.1% (53,243) had general anesthesia alone, 17.8% (12,011) had general anesthesia and a nerve block, and 3.1% (2062) had a nerve block alone. Overall, the complication rate was 13.3% and 30-day mortality was 1.2 per 1000 (95% CI 0.9, 1.4). In adjusted analyses, patients who had general anesthesia alone (compared to general anesthesia and nerve block) had a 16% increase in all cause infectious complications (OR 1.16, 95% CI: 1.03, 1.31) and were 2.6 times more likely to develop pulmonary complications (OR 2.6, 95% CI: 1.14, 5.78). General anesthesia alone (relative to either block only or general anesthesia and block) was associated with substantial increases in the likelihood of blood transfusions, intensive care unit transfers, and prolonged length of stay. Conclusion Patients receiving regional anesthesia for shoulder arthroplasty may have a reduction in perioperative complications, the need for intensive care unit transfers, blood transfusions, and prolonged hospital stays. |
| Databáze: | OpenAIRE |
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