Osteoarthritis, Pain
Conditions
Keywords
orthopedics, anesthesiology, nerve block, length of stay, Patient readmission
Brief summary
Pain is common after knee replacement surgery and can impact a variety of patient outcomes. Peripheral nerve blocks provide improved pain control and may improve function. However, their impact on other outcomes is poorly described. Therefore, this comparative effectiveness study will estimate the independent association between nerve blocks and health outcomes after knee replacement surgery.
Detailed description
This retrospective, population-based cohort study will evaluate the comparative effectiveness of peripheral nerve blocks on patient and health system outcomes after elective total knee replacement surgery. The investigators will develop a non-parsimonious propensity score to control for potential indication bias and confounding in this observational study. Using the propensity score the investigators will match patients who receive a peripheral nerve block to a patient who did not to estimate the independent association of peripheral nerve blocks with our study outcomes.
Interventions
OTHERPeripheral nerve block
A physician billing code for deposition of a local anesthetic solution around an anatomically defined nerve or nerve plexus
Sponsors
Ottawa Hospital Research Institute
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* first primary total knee replacement during the study period
Exclusion criteria
* Revision arthroplasty
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hospital length of stay | Day of surgery to day of discharge, or up to 365 days, whichever comes first | Determined from the Canadian Institute for Health Information Discharge Abstract Database record for the index hospitalization |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital readmission | The outcome ascertainment window starts on the day of discharge and extends up to 30 days after surgery. Any readmission in this time period will be considered an event. | Determined from the Canadian Institute for Health Information Discharge Abstract Database through identification of a new record after discharge from the index hospitalization |
| In-hospital fall | hospital admission | Determined using validated International Classification of Diseases Tenth edition codes for falls from the index hospitalization Discharge Abstract Database record |
| Emergency department visit | The outcome ascertainment window starts on the day of discharge and extends up to 30 days after surgery. Any emergency department visit in this time period will be considered an event. | Defined as the creation of a record in the National Ambulatory Care Reporting System for an emergency department visit that occurs after discharge and before 30 days after discharge |
Other
| Measure | Time frame | Description |
|---|---|---|
| All cause mortality | Day of surgery to 30 days after surgery | Identified from the Registered Person's Database that records the date of death for all residents of Ontario |
Countries
Canada
Outcome results
None listed