Table 3.
Perioperative practice for total hip and knee arthroplasty patients in nine hospitals
| Perioperative practice | Whole cohort (n = 186) | DRHs (n = 57) | TCHs (n = 129) |
p-value |
|---|---|---|---|---|
| Preoperative | ||||
| Patient attended an optimisation clinic | 67 (36.2) | 13 (22.8) | 54 (42.2) | 0.01 |
| Patient received multidisciplinary education | 74 (40.0) | 25 (43.9) | 49 (38.3) | 0.5 |
| Patient had full body anti-septic wash | 55 (30.1) | 12 (21.1) | 43 (34.1) | 0.07 |
| Patient received analgesia | 125 (67.9) | 31 (54.4) | 94 (74.0) | 0.01 |
| Clear fluids provided 2–6 h before surgery | 37 (20.0) | 8 (14.0) | 29 (22.7) | 0.2 |
| Solids provided 6–10 h before surgery | 42 (23.1) | 18 (31.6) | 24 (19.2) | 0.07 |
| Treatment of anaemia initiateda | 4/40 (10) | None | 4 (12.9) | 0.6 |
| Intraoperative | ||||
| THA: Operative time (minutes) | 90 (75–106) | 91 (80–118) | 90 (71–106) | 0.6 |
| TKA: Operative time (minutes) | 105 (85–125) | 113 (97–126) | 100 (73–125) | 0.06 |
| Antibiotics ≤ 30 min before skin cut | 185 (100) | 57 (100) | 128 (100) | |
| THA: Performance of PNB and/or LIA | 30 (36.1) | 15 (60.0) | 15 (25.9) | 0.003 |
| TKA: Performance of PNB and/or LIA | 62 (66.7) | 26 (92.9) | 36 (55.4) | < 0.001 |
| Neuraxial (spinal) anaesthesia | 121 (65.1) | 47 (82.5) | 74 (57.4) | 0.001 |
| Administration of tranexamic acid | 178 (96.2) | 57 (100) | 121 (94.5) | 0.1 |
| Blood transfusion | 1 (0.5) | None | 1 (0.8) | 1.0 |
| Use of active warming device | 179 (97.3) | 55 (96.5) | 124 (97.6) | 0.6 |
| Postoperative day 1 | ||||
| Patient mobilised out of bed | 69 (38.1) | 36 (65.5) | 33 (26.2) | < 0.001 |
| Patient received paracetamol + NSAIDb | 29 (16.0) | 14 (25.5) | 15 (11.9) | 0.02 |
| Patient received antithrombotic therapyb | 149 (85.1) | 46 (85.2) | 103 (85.1) | 1.0 |
| Patient assessed by pain management team | 103 (57.5) | 32 (59.3) | 71 (56.8) | 0.8 |
| Use of patient-controlled analgesiab | 82 (45.3) | 23 (41.8) | 59 (46.8) | 0.5 |
Data are n (%) or median (IQR)
a = 40 patients (21.5%) presented with anaemia, 4 (10.0%) had initiated medical treatment to increase haemoglobin concentration; b = drugs administered since conclusion of surgery
Please see the Abbreviations section for explanation of the acronyms and Supplementary data, Tables S2-S5 for definitions of perioperative interventions and Table S8 for reporting of missing data