Racial and Ethnic Differences in the Use of Regional Anesthesia for Patients Undergoing Total Knee Arthroplasty

被引:11
作者
Adeola, Janet O. [1 ]
Wall, Pelle V. [2 ]
Mehdipour, Soraya [2 ]
Macias, Alvaro A. [2 ]
Gabriel, Rodney A. [2 ,3 ,4 ,5 ]
机构
[1] Harvard Med Sch, Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, Boston, MA USA
[2] Univ Calif San Diego, Dept Anesthesiol, Div Reg Anesthesia, San Diego, CA 92103 USA
[3] Univ Calif San Diego, Dept Anesthesiol, Div Perioperat Informat, San Diego, CA 92103 USA
[4] Univ Calif San Diego, Dept Biomed Informat, San Diego, CA 92103 USA
[5] Univ Calif San Diego, Dept Anesthesiol, Dept Biomed Informat, 200 West Arbor Dr Suite 770, San Diego, CA 92103 USA
关键词
racial disparities; regional anesthesia; knee arthroplasty; nerve block; NSQIP; DISPARITIES; CARE; REVISION; RACE; HIP;
D O I
10.1016/j.arth.2023.03.032
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: There is an increasing body of evidence that suggests racial and ethnic disparities exist in medical care. In the field of anesthesiology, few studies have investigated the association of race and ethnicity with the provision of regional anesthesia for patients undergoing total knee arthroplasty. This analysis queried a large national surgical database to determine whether there were racial or ethnic differences in the administration of peripheral nerve blocks for patients undergoing total knee arthroplasty.Methods: In this retrospective cohort study, data were collected from a large national database during the years 2017-2019. Multivariable logistic regressions were used to measure the association of race and ethnicity with utilization of regional anesthesia. The participants for the study were patients 18 years or older undergoing total knee arthroplasty.Results: Our primary finding was that among patients undergoing total knee arthroplasty, Black patients had lower odds (adjusted odds ratio [aOR]: 0.93, 99% confidence interval [CI]: 0.89-0.98) of receiving regional anesthesia than White patients. Also, Hispanic patients had lower odds (aOR: 0.88, 99% CI: 0.830.94) of receiving regional anesthesia than non-Hispanic patients. Native Hawaiian/Pacific Islander patients had increased odds (aOR: 2.04, 99% CI: 1.66-2.51) of receiving regional anesthesia.Conclusion: This study demonstrated that there might be racial and ethnic differences in the provision of regional anesthesia for patients undergoing total knee arthroplasty. These differences underscore the need for more studies aimed at equitable access to high quality and culturally competent health care.& COPY; 2023 Elsevier Inc. All rights reserved.
引用
收藏
页码:1663 / 1667
页数:5
相关论文
共 25 条
[1]   Socioeconomic disparities in health: Pathways and policies [J].
Adler, NE ;
Newman, K .
HEALTH AFFAIRS, 2002, 21 (02) :60-76
[2]   Association of race and ethnicity in the receipt of regional anesthesia following mastectomy [J].
Beletsky, Alexander ;
Burton, Brittany Nicole ;
Finneran, John J. ;
Alexander, Brenton S. ;
Macias, Alvaro ;
Gabriel, Rodney Allanigue .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2021, 46 (02) :118-123
[3]   Racial Disparities in the Use of Surgical Procedures in the US [J].
Best, Matthew J. ;
McFarland, Edward G. ;
Thakkar, Savyasachi C. ;
Srikumaran, Uma .
JAMA SURGERY, 2021, 156 (03) :274-281
[4]   Race and Outcomes in Patients with Congenital Cardiac Disease in an Enhanced Recovery Program [J].
Buchanan, Rica ;
Roy, Nathalie ;
Parra, M. Fernanda ;
Staffa, Steven J. ;
Brown, Morgan L. ;
Nasr, Viviane G. .
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2022, 36 (09) :3603-3609
[5]   Epidemiology, trends, and disparities in regional anaesthesia for orthopaedic surgery [J].
Cozowicz, C. ;
Poeran, J. ;
Memtsoudis, S. G. .
BRITISH JOURNAL OF ANAESTHESIA, 2015, 115 :57-67
[6]   Regional vs. General Anesthesia for Total Knee and Hip Replacement: An Analysis of Postoperative Pain Perception from the International PAIN OUT Registry [J].
Donauer, Katharina ;
Bomberg, Hagen ;
Wagenpfeil, Stefan ;
Volk, Thomas ;
Meissner, Winfried ;
Wolf, Alexander .
PAIN PRACTICE, 2018, 18 (08) :1036-1047
[7]   Racial Disparity in the Perioperative Care for Patients Undergoing Total Knee and Hip Arthroplasty: A Retrospective Propensity-Matched Cohort Study [J].
Elsharydah, Ahmad ;
Embabi, Ahmed S. ;
Minhajuddin, Abu ;
Joshi, Girish P. .
JOURNAL OF RACIAL AND ETHNIC HEALTH DISPARITIES, 2018, 5 (03) :632-637
[8]  
Ibrahim SA, 2002, MED CARE, V40, P44
[9]   Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee A Randomized Clinical Trial [J].
Ibrahim, Said A. ;
Blum, Marissa ;
Lee, Gwo-Chin ;
Mooar, Pekka ;
Medvedeva, Elina ;
Collier, Aliya ;
Richardson, Diane .
JAMA SURGERY, 2017, 152 (01)
[10]   Defining Racial and Ethnic Disparities in THA and TKA [J].
Irgit, Kaan ;
Nelson, Charles L. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2011, 469 (07) :1817-1823