Impact of Peripheral Nerve Blockade on Outcomes After Total Knee Replacement

Completed

• Conditions: Pain; Osteoarthritis
• Interventions: Other: Peripheral nerve block

• Registration Number: NCT02742961
• Lead Sponsor: Ottawa Hospital Research Institute

Brief Summary

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.

Detailed Description

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 Timeline

• Study Start: 2002-04
• Primary Completion: 2014-03
• Study Completion: 2014-03
• Status Verified: 2016-04
• Study First Submitted: 2016-04-13
• Study First Submitted QC: 2016-04-18
• Last Update Submitted: 2016-04-18
• Study First Posted: 2016-04-19
• Last Update Posted: 2016-04-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 178214

Inclusion Criteria

• first primary total knee replacement during the study period

Exclusion Criteria

• Revision arthroplasty

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Peripheral nerve block	Peripheral nerve block	Intervention arm. Participants who receive a peripheral nerve block identified through submission of an appropriate physician billing code

Primary Outcome Measures

Name	Time	Method
Hospital length of stay	Day of surgery to day of discharge, or up to 365 days, whichever comes first	Determined from the Canadian Institute for Health Information Discharge Abstract Database record for the index hospitalization

Secondary Outcome Measures

Name	Time	Method
Hospital readmission	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.	Determined from the Canadian Institute for Health Information Discharge Abstract Database through identification of a new record after discharge from the index hospitalization
In-hospital fall	hospital admission	Determined using validated International Classification of Diseases Tenth edition codes for falls from the index hospitalization Discharge Abstract Database record
Emergency department visit	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.	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

Trial Locations

Locations (1)

Ottawa Hospital Research Institute; 🇨🇦 Ottawa, Ontario, Canada