scholarly journals Comparative perioperative outcomes associated with anesthetic technique for total hip arthroplasty: a retrospective cohort study

2019 ◽  
Author(s):  
Qing Fang ◽  
Yan-Lin Wang ◽  
Zong-Ze Zhang ◽  
Hong-Yu Wang ◽  
Huan Luo ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Spinal Anesthesia ◽  
Hip Arthroplasty ◽  
Adjusted Odds Ratio ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Perioperative Outcomes ◽  
Anesthetic Technique ◽  
Total Hip ◽  
Intraoperative Hypotension

Abstract Background The influence of anesthetic technique on perioperative outcomes for total hip arthroplasty remains poorly elucidated. We studied a sample of total hip arthroplasty recipients, hypothesizing that spinal anesthesia has a superior impact on perioperative outcomes. Methods We conducted a retrospective cohort study of patients undergoing total hip arthroplasty between December 1, 2012 and October 31, 2018 in Zhongnan Hospital of Wuhan University. The primary outcome was cardiorespiratory complications. Secondary outcomes were intraoperative hypotension, packed red blood cells (pRBCs) transfusion, prolonged hospital length of stay, intensive care unit (ICU) use, life-threatening event, and mortality. Multivariable regression analyses were used to identify the impact of anesthetic technique on perioperative outcomes. Results Among the 1,233 patients, 561 had general anesthesia, and 672 had spinal anesthesia. Patients were averagely younger in general group than in spinal anesthesia group, (69.0 and 72.1 years, respectively; P < 0.001), with insignificant difference in comorbidity burden. When spinal anesthesia was used, the hospital length of stay, ICU times, and volume of pRBCs transfusion were significant decreased (P < 0.05). Life-threatening event and in-hospital mortality occurred frequently in general anesthesia, but with insignificant difference. After adjusting for covariates, spinal anesthesia was associated with 54.3% reduction in cardiorespiratory complications (adjusted odds ratio [OR]: 0.457, 95% confidence interval [CI]: 0.320–0.652; P < 0.001). Spinal anesthesia was favorably associated with decreased odds for intraoperative hypotension (OR: 0.653, 95% CI: 0.494–0.863; P = 0.003) and ICU use (OR: 0.371, 95% CI: 0.268–0.514; P < 0.001). The use of spinal anesthesia was not found to influence the risk of pRBCs transfusion (adjusted odds ratio [OR]: 0.823, 95% CI: 0.631–1.073; P = 0.149) and prolonged hospital length of stay (adjusted odds ratio [OR]: 0.886, 95% CI: 0.684–1.148; P = 0.360). Conclusions Compared with general anesthesia, spinal anesthesia for total hip arthroplasty was associated with decreased rates of cardiorespiratory complications, intraoperative hypotension, and ICU use.

Day of Surgery and Surgical Start Time Affect Hospital Length of Stay After Total Hip Arthroplasty

2016 ◽  
Vol 31 (11) ◽  
pp. 2426-2431 ◽  
Author(s):  
Aakash Keswani ◽  
Christina Beck ◽  
Kristen M. Meier ◽  
Adam Fields ◽  
Michael J. Bronson ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Start Time ◽  
Total Hip

scholarly journals Total hip arthroplasty for femoral neck fractures as an urgent procedure

2017 ◽  
Vol 74 (5) ◽  
pp. 450-455
Author(s):  
Dragan Radoicic ◽  
Zarko Dasic ◽  
Milorad Mitkovic ◽  
Srdjan Starcevic
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Hospital Length ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Total Hip ◽  
Neck Fracture ◽  
Urgent Procedure

Background/Aim. Total hip arthroplasty (THA) is one of the most widely accepted operative methods for femoral neck fracture (FNF) in elderly. However, the data on the early THA for FNF are very limited. The aim of this study to determine if there were differences in postoperative complications and functional outcomes between an urgent and delayed THA following FNF. Methods. This prospective study included a total of 244 patients who had THA following FNF from January 2010 to January 2013. In the first group 41 FNF patients were treated with THA within less than 12 hours of admission. A total of 203 FNF patients were operated in delayed settings, of whom 162 required prolonged preoperative processing and comorbidities correction. The group II consisted of 41 FNF patients who were fit for the early surgery at admission, but the operation was delayed due to institution related reasons. Main outcome measurements included mortality, functional outcome assessement, cardiological and pulmonary complications, pressure ulcers, dislocations, infections, length of hospitalization and revisions. Results. There were no differences in terms of age, gender, type of implants, neither in mortality, nor complications. There were differences in hospital length of stay [t (51.72) = -10.25, p < 0.001)]. The patients operated within less than 12 hours of admission, had significantly better scores at all three time points of functional outcome assessment: at discharge t (80) = 2.556, p < 0.012; one month t (80) = 4.731, p < 0.001; three months t (80) = 5.908, p < 0.001. Conclusion. THA for FNF as an urgent procedure is not a widely accepted concept. Our findings indicate that the early operative treatment, does not worsen clinical outcomes, and our results give an advantage to the policy of the early THA for FNF.

scholarly journals TOTAL HIP REPLACEMENT AND RELATED DIAGNOSIS RELATED GROUPS (DRG's) IN THE GREEK HEALTHCARE SYSTEM

2016 ◽  
Vol 11 (5) ◽  
pp. 2986-2987
Author(s):  
Georgios I. Tagarakis ◽  
Costas Dikeos ◽  
Nikolaos Tsilimingas ◽  
Charalampos Tsairidis ◽  
Fani Tsolaki ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Diagnosis Related Groups ◽  
Clinical Results ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Clinical Protocols ◽  
Total Hip ◽  
And Performance

Aim. To evaluate the Greek Diagnosis Related Groups(DRG's)system in regard to the procedure of total hip arthroplasty. Methods. In a tertiary university orthopedics department implementing clinical protocols we recruited 75 consecutive patients planned to undergototal hip arthroplasty. Indicators of quality and performance were rates of mortality, pulmonary embolism, trauma dehiscence, disarticulation and readmission. Results. All rates of performance were excellent and equal to zero. The mean length of stay was almost identical to the one predicted by the Greek DRG's. Conclusions. Clinical protocols are connected with good clinical results. The predicted by the Greek DRG's hospital length of stay for total hip arthroplasty lies within pragmatic limits. 

Letter to the Editor on “Day of Surgery and Surgical Start Time Affect Hospital Length of Stay After Total Hip Arthroplasty”

2017 ◽  
Vol 32 (7) ◽  
pp. 2318
Author(s):  
Borja de la Hera ◽  
María Alvarez-Postigo ◽  
Renato Delfino ◽  
Diego Garcia-Garcia ◽  
Maria J. Rayo
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Start Time ◽  
Total Hip ◽  
Letter To The Editor

scholarly journals Preoperative Pain Level and Patient Expectation Predict Hospital Length of Stay After Total Hip Arthroplasty

2015 ◽  
Vol 30 (4) ◽  
pp. 555-558 ◽  
Author(s):  
Mohamad J. Halawi ◽  
Tyler J. Vovos ◽  
Cindy L. Green ◽  
Samuel S. Wellman ◽  
David E. Attarian ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Pain Level ◽  
Preoperative Pain ◽  
Patient Expectation ◽  
Total Hip

Preoperative Hyponatremia is a Risk Factor for Adverse 30-Day Outcomes Following Total Hip Arthroplasty

2020 ◽  
Vol 04 (01) ◽  
pp. 007-014
Author(s):  
Joseph E. Tanenbaum ◽  
Thomas T. Bomberger ◽  
Derrick M. Knapik ◽  
Steven J. Fitzgerald ◽  
Nihar S. Shah ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Improvement Program ◽  
Surgical Quality ◽  
Total Hip

AbstractThe relationship between preoperative hyponatremia and 30-day outcomes following total hip arthroplasty (THA) is currently unknown. The present study used prospectively collected data to quantify the association between preoperative hyponatremia and odds of major morbidity (MM), longer length of stay, readmission, and reoperation within 30 days following THA. Patients who underwent THA between 2012 and 2014 were identified in the National Surgical Quality Improvement Program database using validated Current Procedural Terminology codes. Patients were included if they were either normonatremic or hyponatremic preoperatively. The outcome measures in this study were 30-day MM, hospital length of stay, 30-day readmission, and 30-day reoperation. A unique multivariable logistic regression model was used for each outcome to identify statistically significant associations between hyponatremia and the outcome of interest after adjusting for covariates. From 2012 to 2014, 59,236 THA procedures were recorded in National Surgical Quality Improvement Program, of which 55,611 patients were normonatremic and 3,051 patients were hyponatremic. After adjusting for covariates, preoperative hyponatremia was significantly associated with increased odds of MM (odds ratio [OR] = 1.14; 99% confidence interval [CI]: 1.01–1.30), 30-day reoperation (OR = 1.18; 99% CI: 1.02–1.36), and longer hospital length of stay (OR = 1.20; 99% CI: 1.13–1.27). Hyponatremia was not significantly associated with greater odds of 30-day readmission (OR = 0.91; 99% CI: 0.82–1.01). Preoperative hyponatremia was significantly associated with adverse 30-day outcomes following THA. As the U.S. health care system continues to transition toward value-based reimbursement that emphasizes health care quality, the results of the present study can be used to improve patient selection and preoperative counseling.

Sign in / Sign up

Export Citation Format

Share Document