TABLE III.
Association of General Anesthesia with Adverse Events and Readmission in Patients Who Had Undergone Hip Arthroplasty
| Bivariate Logistic Regression |
Propensity-Adjusted Multivariate Logistic
Regression§ |
|||||
| Outcome | General Anesthesia* | Spinal Anesthesia* | Odds Ratio† | P Value‡ | Odds Ratio† | P Value‡ |
| Any adverse event | 23.51% | 19.65% | 1.26 (1.17 to 1.35) | <0.001 | 1.31 (1.23 to 1.41) | <0.001 |
| Any severe adverse event | 3.81% | 3.69% | 1.03 (0.89 to 1.20) | 0.653 | 1.04 (0.90 to 1.20) | 0.618 |
| Death | 0.15% | 0.13% | 1.11 (0.52 to 2.33) | 0.786 | 1.19 (0.57 to 2.53) | 0.632 |
| Ventilator use for more than forty-eight hours | 0.14% | 0.02% | 5.78 (1.34 to 24.93) | 0.019 | 5.81 (1.35 to 25.06) | 0.018 |
| Unplanned intubation | 0.28% | 0.13% | 2.10 (1.07 to 4.13) | 0.031 | 2.17 (1.11 to 4.29) | 0.024 |
| Stroke or cerebrovascular accident | 0.17% | 0.07% | 2.35 (0.95 to 5.81) | 0.063 | 2.51 (1.02 to 6.20) | 0.046 |
| Thromboembolic event (deep vein thrombosis or pulmonary embolism) | 0.64% | 0.59% | 1.08 (0.76 to 1.55) | 0.661 | 1.10 (0.77 to 1.57) | 0.617 |
| Surgical site infection | 1.25% | 1.30% | 0.96 (0.76 to 1.24) | 0.798 | 0.94 (0.73 to 1.20) | 0.609 |
| Sepsis or septic shock | 0.38% | 0.34% | 1.12 (0.71 to 1.79) | 0.623 | 1.11 (0.70 to 1.77) | 0.662 |
| Cardiac arrest | 0.12% | 0.02% | 4.81 (1.10 to 21.1) | 0.037 | 5.04 (1.15 to 22.07) | 0.032 |
| Myocardial infarction | 0.26% | 0.24% | 1.06 (0.61 to 1.84) | 0.840 | 1.14 (0.65 to 1.99) | 0.648 |
| Acute renal failure | 0.08% | 0.06% | 1.28 (0.44 to 3.76) | 0.648 | 1.32 (0.45 to 3.86) | 0.617 |
| Return to the operating room | 1.76% | 1.88% | 0.93 (0.76 to 1.15) | 0.507 | 0.93 (0.76 to 1.14) | 0.489 |
| Wound dehiscence | 0.13% | 0.09% | 1.55 (0.65 to 3.76) | 0.323 | 1.53 (0.63 to 3.70) | 0.344 |
| Graft, prosthesis, or flap failure | 0.03% | 0.01% | 2.56 (0.29 to 22.98) | 0.399 | 2.67 (0.30 to 23.98) | 0.380 |
| Peripheral nerve injury | 0.07% | 0.06% | 1.15 (0.39 to 3.45) | 0.796 | 1.11 (0.37 to 3.31) | 0.857 |
| Any minor adverse event | 20.95% | 17.14% | 1.28 (1.19 to 1.38) | <0.001 | 1.35 (1.25 to 1.45) | <0.001 |
| Blood transfusion | 19.79% | 16.24% | 1.27 (1.18 to 1.37) | <0.001 | 1.34 (1.25 to 1.45) | <0.001 |
| Urinary tract infection | 1.29% | 1.04% | 1.24 (0.96 to 1.63) | 0.098 | 1.29 (0.99 to 1.68) | 0.056 |
| Pneumonia | 0.31% | 0.22% | 1.39 (0.79 to 2.43) | 0.247 | 1.45 (0.83 to 2.53) | 0.198 |
| Progressive renal insufficiency | 0.11% | 0.04% | 3.00 (0.86 to 10.43) | 0.085 | 2.92 (0.84 to 10.19) | 0.092 |
| Readmission# | 3.60% | 3.39% | 1.06 (0.91 to 1.25) | 0.444 | 1.09 (0.93 to 1.29) | 0.291 |
*
The values are given as the percentage of patients.
†
The values are given as the odds ratio, with the 95% CI in parentheses.
‡
Significance was set at p < 0.05.
§
Each line represents a separate multivariate analysis for each variable to give an adjusted odds ratio and p value by controlling for patient characteristics and propensity score.
#
Readmission data were available only for 2011 and 2012: 18,128 patients, 10,988 (60.6%) of whom received general anesthesia.