Original Research
Correlation of Postoperative Epidural Analgesia With Morbidity and Mortality Following Total Knee Replacement in Medicare Patients
Am J Orthop. 2008 October;37(10):524-527
Author and Disclosure Information
Christopher L. Wu, MD, James S. Demeester, MD, Robert Herbert, David N. Maine, MD, Andrew J. Rowlingson, BA, and Lee A. Fleisher, MD
Dr. Wu is Associate Professor, and Dr. Demeester is Fellow, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
Mr. Herbert is Research Associate, Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Dr. Maine is Fellow, and Mr. Rowlingson is Research Assistant, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
Dr. Fleisher is Professor and Chair; Department of Anesthesia, University of Pennsylvania, Philadelphia, Pennsylvania.
It is unclear whether perioperative epidural analgesia is associated with a decrease in mortality in patients who undergo orthopedic procedures. We examined 35,878 patients’ data obtained from a random sample of Medicare beneficiaries who underwent elective total knee replacement. Division of patients into 2 groups was based on presence or absence of billing for postoperative epidural analgesia. Outcomes assessed were death and major morbidity 30 days after surgery. Multivariate regression analysis revealed no between-groups difference in mortality 30 days after surgery. Postoperative epidural analgesia was not associated with lower incidence of mortality or major morbidity in Medicare patients who underwent elective total knee replacement.