Associated risk factors with worse functional prognosis and hip replacement surgery in ankylosing spondylitis

Background: Authors report two cases of regional anesthesia management whom were scheduled for total hip replacement surgery due to ankylosing spondylitis.Methods: Mouth opening, and cervical spine movements were limited. Cervical ostheophytes have been recognized to cause distortion of the airway and can lead to unexpected difficulties during intubation.Results: In present first case report we described continuous spinal anesthesia for a patient with severe ankylosing spondylitis. We achieved successful anesthesia using epidural catheter by insertion of spinal area. Awake epidural anesthesia management was described in second case of the study.Conclusions: Authors suggest that regional anesthesia can be safely and effectively used as an alternative to general anesthesia in patients with ankylosing spondylitis.

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Potential Opioid-Related Adverse Drug Events Are Associated With Decreased Revenue in Hip Replacement Surgery in the Older Population

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320915328 ◽

2020 ◽

Vol 11 ◽

pp. 215145932091532

Author(s):

Justin Baker ◽

Ethan Y. Brovman ◽

Nikhilesh Rao ◽

Sascha S. Beutler ◽

Richard D. Urman

Keyword(s):

Risk Factors ◽

Hip Replacement ◽

Older Patients ◽

Adverse Drug Events ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Replacement Surgery ◽

Hip Replacement Surgery ◽

Hospital Revenue ◽

The Mean

Introduction: Opioid-related adverse drug events (ORADEs) are an increasingly recognized complication associated with the common prescription of opioids after orthopedic surgery. In this study, we attempted to understand how potential ORADEs following hip replacement surgery in older patients affected hospital length of stay, hospital revenue, and their association with specific risk factors and clinically relevant diseases occurring during hospitalization. Methods: We conducted a retrospective study using the Centers for Medicare and Medicaid Services Administrative Database to analyze Medicare discharges after hip replacement surgery to identify potential ORADEs. The impact of potential ORADEs on mean hospital length of stay (LOS) and hospital revenue was analyzed. Results: The potential ORADE rate in patients who underwent hip replacement surgery was 8.6%. The mean LOS for discharges with a potential ORADE was 1.41 days longer than that for discharges without an ORADE. The mean hospital revenue per day with a potential ORADE was US$1708 less than without an ORADE. Potential ORADEs were also found to be strongly associated with poor patient outcomes such as pneumonia, septicemia, and shock. Discussion: Potential ORADEs in hip replacement surgery in older patients are associated with longer hospitalizations, decreased hospital revenue per day, certain patient risk factors, and clinically relevant diseases occurring during hospitalizations. Our finding of an association between potential ORADEs and decreased hospital revenue per day may be attributed to the management of these adverse events, as a patient may need to undergo additional testing, may need additional treatment regimens, and may need a higher level of care. Conclusion: By reducing the use of opioids and employing a multimodal analgesic approach, we may improve patient care, decrease hospital lengths of stay, and increase hospital revenue

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Hip replacement surgery in patients with ankylosing spondylitis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2013-203963 ◽

2013 ◽

Vol 73 (6) ◽

pp. 1194-1197 ◽

Cited By ~ 11

Author(s):

Tone Wikene Nystad ◽

Ove Furnes ◽

Leif Ivar Havelin ◽

Arne Kristian Skredderstuen ◽

Stein Atle Lie ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Hip Replacement ◽

Replacement Surgery ◽

Hip Replacement Surgery

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Incidence and Associated Risk Factors for Falls in Older Adults Postdischarge Who Undergo Elective Total Hip Replacement Surgery—A Prospective Cohort Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa283 ◽

2020 ◽

Author(s):

Anne-Marie Hill ◽

Gail Ross-Adjie ◽

Steven M McPhail ◽

Angela Jacques ◽

Max Bulsara ◽

...

Keyword(s):

Older Adults ◽

Total Hip Replacement ◽

Hip Replacement ◽

Odds Ratio ◽

Total Hip ◽

Replacement Surgery ◽

Hip Replacement Surgery ◽

Falls In Older Adults ◽

Associated Risk Factors ◽

Risk Factors For Falls

Abstract Background Hip replacement surgery improves health-related quality of life; however, it has been suggested that falls rates increase after hospital discharge. The aim of the study was to determine the incidence and associated risk factors for falls in older adults in the 12 months after undergoing elective total hip replacement surgery. Methods A prospective observational cohort study was conducted. Participants were adults aged 60 years or older who underwent primary elective total hip replacement surgery in a private tertiary hospital in Perth, Australia. Baseline data collected immediately prior to discharge included use of walking aids, medications, and functional level of independence (using Katz and Lawton scales). Falls data were collected for 12 months using calendars and monthly phone calls. Data were analyzed using logistic and negative binomial regression modeling. Results Participants’ ([n = 167], 54.4% female) mean age was 71.2 (±6.9) years. There were 51 (31%) participants who used a walking aid prior to surgery. There were 140 falls reported over 12 months by 67 (42%) participants, of which 90 (64.3%) were injurious (n = 9 fractures). The fall rate was 2.6 per 1000 patient-days. Age (adjusted odds ratio 1.10, 95% confidence interval 1.01–1.20) and hospital length of stay (adjusted odds ratio 1.24, 95% confidence interval 1.00–1.54).were significantly associated with sustaining multiple falls. Conclusions More than 40% of older adults fell in the 12 months after elective hip replacement surgery although the cohort had low fall risk prior to surgery. Rehabilitation after hip replacement surgery should consider fall prevention.

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