title: Variability in anesthetic care for total knee arthroplasty: an analysis from the anesthesia quality institute.
abstract: Anesthetic practice utilization and related characteristics of total knee arthroplasties (TKAs) are understudied. The research team sought to characterize anesthesia practice patterns by utilizing National Anesthesia Clinical Outcomes Registry data of the Anesthesia Quality Institute. The proportions of primary TKAs performed between January 2010 and June 2013 using general anesthesia (GA), neuraxial anesthesia (NA), and regional anesthesia (RA) were determined. Utilization of anesthesia types was analyzed using anesthesiologist and patient characteristics and facility type. In all, 108 625 eligible TKAs were identified; 10.9%, 31.3%, and 57.9% were performed under RA, NA, and GA, respectively. Patients receiving RA had higher median age and higher frequency of American Society of Anesthesiology score ≥3 compared with those receiving other anesthesia types under study. Relative to GA (45.0%), when NA or RA were used, the anesthesiologist was more frequently board certified (75.5% and 62.1%, respectively; P < .0001). Anesthetic technique differences for TKAs exist, with variability associated with patient and provider characteristics.
authors.affiliation: Weill Cornell Medical College, New York, NY pmf9003@med.cornell.edu.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Fleischut
authors.affiliation: Anesthesia Quality Institute, Chicago, IL.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Eskreis-Winkler
authors.affiliation: Weill Cornell Medical College, New York, NY.
authors.forename: Licia K
authors.initials: LK
authors.lastname: Gaber-Baylis
authors.affiliation: Weill Cornell Medical College, New York, NY.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Giambrone
authors.affiliation: Weill Cornell Medical College, New York, NY.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Faggiani
authors.affiliation: Anesthesia Quality Institute, Chicago, IL.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Dutton
authors.affiliation: Hospital for Special Surgery, New York, NY.
authors.forename: Stavros G
authors.initials: SG
authors.lastname: Memtsoudis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000777:Anesthetics / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D055815:Young Adult
chemical_list: D000777:Anesthetics
keywords: AQI; NACOR; anesthesia practice patterns; total knee arthroplasty