Abstract
In this study, we aim to better understand how spinal block, anticoagulant, and antifibrinolytic drug treatments are associated with hospital costs, lengths of stay, prevalence of early readmissions, and prevalence of blood transfusions for total knee replacement patients. Analysis of variance, multiple comparison testing, ordinary least squares regression, and logistic regression were used to identify which combinations of these drug treatments were associated with higher or lower health outcomes. The combination of Lidocaine and Ropivacaine was the spinal block treatment associated with the highest mean hospital cost, length of stay, highest proportion of early readmissions, and required blood transfusions. The combination of Warfarin and Enoxaparin was the anticoagulant treatment associated with the highest mean hospital cost, length of stay, and highest proportion of early readmissions. Patients who received Tranexamic Acid had a significantly shorter length of stay, smaller likelihood of a blood transfusion, and no significant difference in hospital cost.
Highlights
More than 4.5 million Americans are currently living with at least one total knee replacement
In this study we aim to better understand how different drug treatments for total knee replacement surgeries are associated with health outcomes such as hospital cost, length of stay, prevalence of early readmissions, and prevalence of blood transfusions
If there is a difference in mean total cost associated with the different spinal block treatments, multiple comparison testing (MCT) will be done to determine which spinal block treatments have significantly smaller/ larger mean total costs associated with them
Summary
More than 4.5 million Americans are currently living with at least one total knee replacement. This group contains almost 5% of the population of all Americans over the age of 50 (Fawzi 2012). Knee arthroplasties, have been on the rise in recent history. From 1997 to 2009, the number of knee arthroplasties increased by 84% (Fawzi 2012). What exactly is a knee replacement and why are they gaining popularity? A knee replacement is a surgical procedure that replaces the surface of the bones that bear the weight of an individual. A replacement is considered when the bone and cartilage mechanism begin to fail due to wear and tear, acute injuries, or disease. Stiffness, swelling, and limited mobility are common side effects of these events (Foran 2011)
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