• Reg Anesth Pain Med · Sep 2014

    Comparative Study

    Regional Anesthesia, Time to Hospital Discharge, and In-Hospital Mortality: A Propensity Score Matched Analysis.

    • Catherine M Bulka, Matthew S Shotwell, Rajnish K Gupta, Warren S Sandberg, and Jesse M Ehrenfeld.
    • From the *Department of Anesthesiology, Vanderbilt University Medical Center; Departments of †Biostatistics, ‡Biomedical Informatics, and §Surgery, Vanderbilt University School of Medicine, Nashville, TN.
    • Reg Anesth Pain Med. 2014 Sep 1; 39 (5): 381-6.

    Background And ObjectivesThe anesthetic technique used during surgery can affect postoperative length of stay and outcomes, even after controlling for other clinically important factors. This study evaluated the impact of regional anesthesia (RA) compared with general anesthesia (GA) on the amount of time between leaving the operating room and hospital discharge and the odds of in-hospital mortality.MethodsSurgical patients admitted after surgery, who received RA, were matched to patients who received GA by propensity score in a 1:4 ratio. We measured the association between anesthetic technique and time to hospital discharge using Kaplan-Meier methods. In-hospital mortality was analyzed using a generalized estimating equation logistic regression model.ResultsA total of 5870 inpatient surgical cases were analyzed; 1174 cases received RA and 4696 cases received GA. The median time to hospital discharge among patients who received RA was 67.6 hours compared with 71.9 hours among patients who received GA (P < 0.0001). A total of 86 cases died in the hospital after surgery; 7 were in the RA cohort and 79 were in the GA cohort. Receiving RA during surgery was associated with 64% lesser odds of dying in the hospital (odds ratio, 0.36; 95% confidence interval, 0.16-0.75), when adjusting for the number of postoperative days spent in the hospital.ConclusionsThe study data provide evidence that median time to discharge is shorter when RA is used instead of GA, controlling for other clinically important factors. Additionally, RA use during surgery was associated with a decrease in in-hospital mortality. When an appropriate option, RA may facilitate faster hospital discharge and improve patient outcomes.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…