Evidence map›Paper›PMID 37910860›Full record

ArticleAnesthesiology2024

Association of Patient Race and Hospital with Utilization of Regional Anesthesia for Treatment of Postoperative Pain in Total Knee Arthroplasty: A Retrospective Analysis Using Medicare Claims.

Anjali A Dixit, Gabriel Sekeres, Edward R Mariano, Stavros G Memtsoudis, Eric C Sun

Open access · greenAbstract read
In one paragraph

Article in Anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 2 countries.

Anjali A DixitDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.ORCID 0000-0002-4327-4832
Gabriel SekeresStanford Institute for Economic Policy Research, Stanford University, Stanford, California.
Edward R MarianoDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.
Stavros G MemtsoudisDepartments of Anesthesiology and Public Health, Weill Cornell Medical College and Hospital for Special Surgery, New York, New York.
Eric C SunDepartment of Anesthesiology, Perioperative and Pain Medicine and Department of Health Policy, Stanford University, Stanford, California.
Economic Policy Institute · USHospital for Special Surgery · USNational Postdoctoral Association · USStanford Health Care · USStanford Medicine · US

Funding

Research in Anesthesia Training Program (ReAP)T32GM089626 · NIGMS · STANFORD UNIVERSITY · PI Vivianne L Tawfik · 2010 to 2026
$5.2M
The Epidemiology and Economics of Chronic Back PainK08DA042314 · NIDA · STANFORD UNIVERSITY · PI SUN, ERIC · 2017 to 2022
$975k
NIDA NIH HHS K08 DA042314NIGMS NIH HHS T32 GM089626
6 · The paper itself

Abstract

backgroundRegional anesthesia for total knee arthroplasty has been deemed high priority by national and international societies, and its use can serve as a measure of healthcare equity. The association between utilization of regional anesthesia for postoperative pain and (1) race and (2) hospital in patients undergoing total knee arthroplasty was estimated. The hypothesis was that Black patients would be less likely than White patients to receive regional anesthesia, and that variability in regional anesthesia would more likely be attributable to the hospital where surgery occurred than race.

methodsThis study used Medicare fee-for-service claims for patients aged 65 yr or older who underwent primary total knee arthroplasty between January 1, 2011, and December 31, 2016. The primary outcome was administration of regional anesthesia for postoperative pain, defined as any peripheral (femoral, lumbar plexus, or other) or neuraxial (spinal or epidural) block. The primary exposure was self-reported race (Black, White, or Other). Clinical significance was defined as a relative difference of 10% in regional anesthesia administration.

resultsData from 733,406 cases across 2,507 hospitals were analyzed: 90.7% of patients were identified as White, 4.7% as Black, and 4.6% as Other. Median hospital-level prevalence of use of regional anesthesia was 51% (interquartile range, 18 to 79%). Black patients did not have a statistically different probability of receiving a regional anesthetic compared to White patients (adjusted estimates: Black, 53.3% [95% CI, 52.5 to 54.1%]; White, 52.7% [95% CI, 52.4 to 54.1%]; P = 0.132). Findings were robust to alternate specifications of the exposure and outcome. Analysis of variance revealed that 42.0% of the variation in block administration was attributable to hospital, compared to less than 0.01% to race, after adjusting for other patient-level confounders.

conclusionsRace was not associated with administration of regional anesthesia in Medicare patients undergoing primary total knee arthroplasty. Variation in the use of regional anesthesia was primarily associated with the hospital where surgery occurred. EDITOR’S PERSPECTIVE:

Indexed as

Anesthesia, ConductionArthroplasty, Replacement, KneeAgedHospitalsHumansMedicarePostoperative PainRetrospective StudiesUnited States

Identifiers

PMID37910860
PMCPMC10872475
OpenAlexW4388122470

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.