Variability in anesthetic care for total knee arthroplasty: an analysis from the anesthesia quality institute.

TitleVariability in anesthetic care for total knee arthroplasty: an analysis from the anesthesia quality institute.
Publication TypeJournal Article
Year of Publication2015
AuthorsFleischut PM, Eskreis-Winkler JM, Gaber-Baylis LK, Giambrone GP, Faggiani SL, Dutton RP, Memtsoudis SG
JournalAm J Med Qual
Volume30
Issue2
Pagination172-9
Date Published2015 Mar-Apr
ISSN1555-824X
KeywordsAdolescent, Adult, Aged, Anesthetics, Arthroplasty, Replacement, Knee, Child, Child, Preschool, Databases, Factual, Female, Humans, Infant, Logistic Models, Male, Middle Aged, Practice Patterns, Physicians', Quality of Health Care, Young Adult
Abstract

Anesthetic practice utilization and related characteristics of total knee arthroplasties (TKAs) are understudied. The research team sought to characterize anesthesia practice patterns by utilizing National Anesthesia Clinical Outcomes Registry data of the Anesthesia Quality Institute. The proportions of primary TKAs performed between January 2010 and June 2013 using general anesthesia (GA), neuraxial anesthesia (NA), and regional anesthesia (RA) were determined. Utilization of anesthesia types was analyzed using anesthesiologist and patient characteristics and facility type. In all, 108 625 eligible TKAs were identified; 10.9%, 31.3%, and 57.9% were performed under RA, NA, and GA, respectively. Patients receiving RA had higher median age and higher frequency of American Society of Anesthesiology score ≥3 compared with those receiving other anesthesia types under study. Relative to GA (45.0%), when NA or RA were used, the anesthesiologist was more frequently board certified (75.5% and 62.1%, respectively; P < .0001). Anesthetic technique differences for TKAs exist, with variability associated with patient and provider characteristics.

DOI10.1177/1062860614525989
Alternate JournalAm J Med Qual
PubMed ID24627358
PubMed Central IDPMC4811028
Grant ListUL1 TR000457 / TR / NCATS NIH HHS / United States
5 UL1 TR000457-07 / TR / NCATS NIH HHS / United States

Center for Perioperative Outcomes
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