Table 4.
Unadjusted and Adjusted Associations Between Patient, Facility, Procedure, and Anesthesia Characteristics of Endoscopic Procedures and Serious Anesthesia Complications—Mixed Effects Multivariate Model (N=256,909)*
| VARIABLE | UNADJUSTED OR (95% CI) | ADJUSTED OR (95% CI)* | |
|---|---|---|---|
| Age (years) | 18 – 49 | 1.00 (referent) | 1.00 (referent) |
| 50 – 64 | 1.02 (0.87, 1.20) | 1.37 (1.01, 1.88) | |
| 65 – 79 | 1.58 (1.35, 1.84) | 1.61 (1.16, 2.23) | |
| >=80 | 2.12 (1.75, 2.56) | 1.75 (1.67, 2.63) | |
|
| |||
| Sex | Female | 1.00 (referent) | 1.00 (referent) |
| Male | 1.29 (1.16, 1.43) | 1.08 (0.87, 1.34) | |
|
| |||
| ASA | ASA 1/2 | 1.00 (referent) | 1.00 (referent) |
| ASA 3 | 1.65 (1.47, 1.86) | 1.27 (0.96, 1.68) | |
| ASA 4/5 | 4.10 (3.49, 4.81) | 3.17 (2.15, 4.67) | |
|
| |||
| Location | Northeast | 1.00 (referent) | 1.00 (referent) |
| South | 4.78 (4.20, 5.44) | 1.52 (0.34, 6.85) | |
| Midwest/West | 0.66 (0.54, 0.82) | 0.86 (0.27, 2.75) | |
|
| |||
| Procedure | Colonoscopy | 1.00 (referent) | 1.00 (referent) |
| EGD^ | 1.63 (1.43, 1.85) | 1.44 (1.12, 1.85) | |
| ERCP | 8.83 (7.70, 10.12) | 1.43 (0.98, 2.08) | |
|
| |||
| Facility Type | Community Hospital | 1.00 (referent) | 1.00 (referent) |
| University Hospital | 0.23 (0.19, 0.29) | 1.80 (0.61, 5.36) | |
| Surgical Center | 0.17 (0.11, 0.25) | 1.24 (0.42, 3.69) | |
|
| |||
| Anesthesia Type | MAC / Sedation | 1.00 (referent) | 1.00 (referent) |
| General | 3.09 (2.75, 3.48) | 2.95 (2.08, 4.18) | |
|
| |||
| Shift | Daytime | 1.00 (referent) | 1.00 (referent) |
| Overnight | 8.47 (7.61, 9.43) | 1.56 (1.00, 2.44) | |
|
| |||
| Emergent Status | Elective | 1.00 (referent) | 1.00 (referent) |
| Emergent | 0.75 (0.51, 1.10) | 2.05 (0.84, 5.03) | |
|
| |||
| Case Duration+ | Short | 1.00 (referent) | 1.00 (referent) |
| Medium | 0.95 (0.74, 1.20) | 1.06 (0.75, 1.50) | |
| Long | 3.49 (2.89, 4.23) | 2.44 (1.78, 3.33) | |
|
| |||
| Facility Volume§ | Low | 1.00 (referent) | 1.00 (referent) |
| Medium | 1.12 (0.91, 1.37) | 0.91 (0.63, 1.33) | |
| High | 5.66 (4.85, 6.60) | 1.42 (0.85, 2.37) | |
N is for model adjusted for age, sex, ASA status, location, procedure, facility type, anesthesia type, shift status, emergent status, case duration, facility volume, as well as facility, practice and provider IDs (mixed effects accounting for unique recording behaviors amongst facilities, practices, and providers).
EGD procedures include enteroscopy and endoscopic ultrasound.
Case duration defined as anesthesia start time to end time.
Facility case volume defined as number of concurrent cases with anesthesia services taking place at the facility at the time of procedure.
Abbreviations: American Society of Anesthesiologists (ASA); Esophagogastroduodenoscopy (EGD); Endoscopic retrograde cholangiopancreatography (ERCP); Monitored anesthesia care (MAC)