Nerve Block Use after Hip Fracture Versus Elective Hip or Knee Arthroplasty: Retrospective Analysis

OBJECTIVES Although peripheral nerve blocks are associated with improved pain control and end outcomes among older adults with hip fracture, their current utilization among US hip fracture patients is not well understood. We characterized contemporary use of peripheral nerve blocks after hip fractur...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2020-04, Vol.68 (4), p.835-840
Main Authors: Neuman, Mark D., Elkassabany, Nabil M., Ochroch, Jason, Newcomb, Craig, Brensinger, Colleen, Mehta, Samir, Gaskins, Lakisha J., Lane‐Fall, Meghan B.
Format: Article
Language:English
Subjects:
Age Distribution
Aged
Aged, 80 and over
Anesthetics
Arthroplasty (hip)
Arthroplasty (knee)
Arthroplasty, Replacement, Hip - methods
Arthroplasty, Replacement, Hip - statistics & numerical data
Arthroplasty, Replacement, Knee - methods
Arthroplasty, Replacement, Knee - statistics & numerical data
Case-Control Studies
Dementia disorders
Female
Fractures
health policy
Health risk assessment
Hip
hip fracture
Hip Fractures - epidemiology
Hip Fractures - therapy
Hospitalization
Humans
Joint replacement surgery
Joint surgery
Male
Middle Aged
Nerve Block - statistics & numerical data
Pain
pain management
Pain Management - methods
Pain, Postoperative - therapy
Peripheral nerves
Retrospective Studies
surgery
Terminology
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Summary:OBJECTIVES Although peripheral nerve blocks are associated with improved pain control and end outcomes among older adults with hip fracture, their current utilization among US hip fracture patients is not well understood. We characterized contemporary use of peripheral nerve blocks after hip fracture over time and identified predictors of nerve block receipt. DESIGN Retrospective cohort study of claims data from one large national private US insurer. SETTING US acute care hospitals. PARTICIPANTS A total of 94 985 adults aged 50 years and older hospitalized for a femoral neck, intertrochanteric, or subtrochanteric fracture; 409 263 adults aged 50 years and older hospitalized for elective hip or knee arthroplasty between 2004 and 2016. MEASUREMENTS Receipt of a peripheral nerve block for pain control, based on Current Procedural Terminology codes in physician service claims. RESULTS Overall, 2874 hip fracture patients (3.0%; 95% confidence interval [CI] = 2.9‐3.1) received a nerve block for pain control, and the percentage receiving a block increased from .4% in 2004‐2006 (95% CI = .3%‐.6%) to 4.6% in 2013‐2016 (95% CI = 4.4%‐4.8%; P 
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.16362