Pain is common after knee replacement surgery and can impact a variety of patient outcomes. Peripheral nerve blocks provide improved pain control and may improve function. However, their impact on other outcomes is poorly described. Therefore, this comparative effectiveness study will estimate the independent association between nerve blocks and health outcomes after knee replacement surgery.
This retrospective, population-based cohort study will evaluate the comparative effectiveness of peripheral nerve blocks on patient and health system outcomes after elective total knee replacement surgery. The investigators will develop a non-parsimonious propensity score to control for potential indication bias and confounding in this observational study. Using the propensity score the investigators will match patients who receive a peripheral nerve block to a patient who did not to estimate the independent association of peripheral nerve blocks with our study outcomes.
Study Type
OBSERVATIONAL
Enrollment
178,214
A physician billing code for deposition of a local anesthetic solution around an anatomically defined nerve or nerve plexus
Ottawa Hospital Research Institute
Ottawa, Ontario, Canada
Hospital length of stay
Determined from the Canadian Institute for Health Information Discharge Abstract Database record for the index hospitalization
Time frame: Day of surgery to day of discharge, or up to 365 days, whichever comes first
Hospital readmission
Determined from the Canadian Institute for Health Information Discharge Abstract Database through identification of a new record after discharge from the index hospitalization
Time frame: The outcome ascertainment window starts on the day of discharge and extends up to 30 days after surgery. Any readmission in this time period will be considered an event.
In-hospital fall
Determined using validated International Classification of Diseases Tenth edition codes for falls from the index hospitalization Discharge Abstract Database record
Time frame: hospital admission
Emergency department visit
Defined as the creation of a record in the National Ambulatory Care Reporting System for an emergency department visit that occurs after discharge and before 30 days after discharge
Time frame: The outcome ascertainment window starts on the day of discharge and extends up to 30 days after surgery. Any emergency department visit in this time period will be considered an event.
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