Perioperative medicine & outcomes
Peripheral nerve‐blocks and associations with length of stay and readmissions in fast‐track total hip and knee arthroplasty
Authors' conclusion
Routine use of peripheral nerve blocks was not associated with early discharge or 30-days readmissions in fast-track THA and TKA.
Study context
- Population
- Fast-track THA and TKA patients in six Danish Arthroplasty Centers, January to August 20172,027 THA, 1432 TKA
- Exposure
- Peripheral nerve blocks (PNB) vs no PNB within fast-track protocols
- Outcome
- LOS >1 day, LOS >4 days and 30-days readmissions
Methodological detailsmulticentre, prospective recording, multiple logistic regression
- Multicentre
- Prospective recording
- Multiple logistic regression
Main finding
As reported in the abstract
LOS >1 day, LOS >4 days, 30-days readmissions (TKA)
PNB vs No PNBOdds ratio (CI)P value
LOS >1 day, TKA
1.19(0.82–1.72)
P = 0.354LOS >4 days, TKA
1.4(0.68–2.89)
P = 0.35930-days readmissions, TKA
1.02(0.63–1.65)
P = 0.935Observational data: associations, not effects.
Further findings
Overall length of stay (LOS)
- Median LOS (IQR 1-2), days
- 1
30-days readmission rate, all patients
- Readmission rate
- 5.3% (CI:4.6-6.1)
PNB use
- TKA
- 40.7% (CI:38.2-43.3)
- THA
- 2.7% (CI:2.0-3.5)
- Interdepartmental variation, TKA
- 0.0-89.0%
Safety
| Outcome | PNB | No PNB |
|---|---|---|
| Mobilization, pain or opioid-related complications (TKA) | 2.1% (CI 1.2–3.6) | 0.1% (CI 0.02–0.7) |
| Falls (TKA) | 0.9% (CI 0.4–2.0) | 0.5% (CI 0.2–1.2) |
| Mobilization, pain or opioid-related complications (THA) | 3.7% (CI 1.0–12.6) | 0.6% (CI 0.3–1.0) |
| Falls (THA) | 0.0% (CI 0.0–6.6) | 0.8% (CI 0.5–1.3) |
Original publication
Peripheral nerve‐blocks and associations with length of stay and readmissions in fast‐track total hip and knee arthroplasty. Acta Anaesthesiol Scand. Published 28 November 2022. doi:10.
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