San Francisco, CA—April 7, 2017
The new research – conducted by conducted by anesthesiologists at Hospital for Special Surgery (HSS) in conjunction with researchers at other institutions, and presented today at the annual meeting of the American Society of Regional Anesthesiologists (ASRA) reported the rates of adverse outcomes such as respiratory and cardiac complications, and hospitalization costs, in patients undergoing lower joint replacements. By analyzing data from 766,100 total knee replacement patients and 354,894 total hip replacement patients enrolled in the Premier Perspective database from 2006 to 2014, the authors found that hospitals that used neuraxial anesthesia in 49 percent to 97 percent of lower joint replacement cases were associated with a 24 percent decreased odds for respiratory and cardiac complications compared to hospitals that used neuraxial anesthesia in zero percent to four percent of lower joint replacement cases. Moreover, compared with hospitals with the lowest neuraxial anesthesia use, hospitals with the highest volume were associated with decreased hospitalization costs: -19 percent and -17 percent in total knee and hip replacements, respectively.
"Hospitals that use neuraxial anesthesia (versus those that don’t), are associated with lower hospitalization cost for lower joint replacements," commented Stavros Memtsoudis, MD, PhD, lead author and senior researcher in the Department of Anesthesiology at HSS. "This may be partly due to lower odds for adverse outcomes, particularly in total knee replacement patients; use of neuraxial anesthesia utilization on a hospital level may very well emerge as an important marker of quality; however, additional studies are needed to elucidate all drivers associated with perioperative outcomes."
Memtsoudis SG, Poeran J, Zubizarreta N, Olson A, Cozowicz C, Mörwald E, Mariano ER, Mazumdar M. “Volume-outcome relationships in anesthesiology: Do hospitals performing high-volume regional anesthesia for hip and knee replacements have better outcomes?” Poster presented at: 2017 ASRA Annual Meeting; April 6-8, 2017; San Francisco, CA.
About HSS | Hospital for Special Surgery
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the eighth consecutive year) and No. 3 in rheumatology by U.S. News & World Report (2017-2018). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In 2017 HSS provided care to 135,000 patients from 80 countries and performed more than 32,000 surgical procedures. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute was formed in 2015 to realize the potential of new drugs, therapeutics and devices; the global standard total knee replacement was developed at HSS in 1969, and in 2017 HSS made 130 invention submissions (more than 2x the submissions in 2015). The HSS Education Institute provides continuing medical curriculum to more than 15,000 subscribing musculoskeletal healthcare professionals in 110 countries. Through HSS Global, the institution is collaborating with medical centers worldwide to advance the quality and value of care and to make world-class HSS care more accessible to more people.