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myxmlFile.xml
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<?xml version="1.0"?>
<!DOCTYPE PubmedArticleSet PUBLIC "-//NLM//DTD PubMedArticle, 1st January 2014//EN" "http://www.ncbi.nlm.nih.gov/corehtml/query/DTD/pubmed_140101.dtd">
<PubmedArticleSet>
<PubmedArticle>
<MedlineCitation Owner="NLM" Status="PubMed-not-MEDLINE">
<PMID Version="1">23874253</PMID>
<DateCreated>
<Year>2013</Year>
<Month>07</Month>
<Day>22</Day>
</DateCreated>
<DateCompleted>
<Year>2013</Year>
<Month>07</Month>
<Day>22</Day>
</DateCompleted>
<DateRevised>
<Year>2013</Year>
<Month>07</Month>
<Day>24</Day>
</DateRevised>
<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Print">1556-3316</ISSN>
<JournalIssue CitedMedium="Print">
<Volume>8</Volume>
<Issue>2</Issue>
<PubDate>
<Year>2012</Year>
<Month>Jul</Month>
</PubDate>
</JournalIssue>
<Title>HSS journal : the musculoskeletal journal of Hospital for Special Surgery</Title>
<ISOAbbreviation>HSS J</ISOAbbreviation>
</Journal>
<ArticleTitle>Regional anesthesia for children undergoing orthopedic ambulatory surgeries in the United States, 1996-2006.</ArticleTitle>
<Pagination>
<MedlinePgn>133-6</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s11420-012-9278-8</ELocationID>
<Abstract>
<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Our objective was to evaluate national trends in regional anesthetic techniques among children undergoing ambulatory orthopedic procedures.</AbstractText>
<AbstractText Label="PURPOSE AND QUESTIONS" NlmCategory="UNASSIGNED">We aimed to determine whether an increase in regional anesthetics was primarily driven by an increase in the number of peripheral nerve blocks performed rather than an increase in neuraxial techniques. We further aimed to determine whether the proportion of peripheral nerve blocks performed in conjunction with general anesthesia has increased over time.</AbstractText>
<AbstractText Label="PATIENTS AND METHODS" NlmCategory="METHODS">Our study sample included any pediatric patient (i.e., <18 years old) who underwent an orthopedic ambulatory procedure in 1996 and 2006. We obtained data on ambulatory surgical procedures by accessing the Centers for Disease Control and Prevention's National Survey of Ambulatory Surgery. Patient demographics (age, gender), procedure information, and anesthesia-related variables were analyzed for each year.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">The proportion of peripheral nerve blocks performed for ambulatory surgery more than doubled from 1996 (4.4 %) to 2006 (8.1 %). A significantly larger proportion of orthopedic procedures were being performed with a combination of peripheral nerve blocks and general anesthesia (1.2 % in 1996 and 43 % 2006). The use of neuraxial anesthesia for lower extremity surgeries decreased over the 10-year period (1.1 and 0.4 % in 1996 and 2006, respectively).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">There was a significant increase in the use of peripheral nerve blocks for children undergoing ambulatory orthopedic procedures in the USA, while neuraxial techniques became less common over the 10-year period. The peripheral nerve blocks were frequently performed in conjunction with general anesthesia.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Kuo</LastName>
<ForeName>Cassie</ForeName>
<Initials>C</Initials>
<Affiliation>Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.</Affiliation>
</Author>
<Author ValidYN="Y">
<LastName>Edwards</LastName>
<ForeName>Alison</ForeName>
<Initials>A</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Mazumdar</LastName>
<ForeName>Madhu</ForeName>
<Initials>M</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Memtsoudis</LastName>
<ForeName>Stavros G</ForeName>
<Initials>SG</Initials>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList>
<PublicationType>Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2012</Year>
<Month>06</Month>
<Day>20</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>United States</Country>
<MedlineTA>HSS J</MedlineTA>
<NlmUniqueID>101273938</NlmUniqueID>
<ISSNLinking>1556-3316</ISSNLinking>
</MedlineJournalInfo>
<OtherID Source="NLM">PMC3715624</OtherID>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="N">ambulatory surgery</Keyword>
<Keyword MajorTopicYN="N">pediatrics</Keyword>
<Keyword MajorTopicYN="N">regional anesthesia</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData>
<History>
<PubMedPubDate PubStatus="received">
<Year>2012</Year>
<Month>1</Month>
<Day>15</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2012</Year>
<Month>4</Month>
<Day>16</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="epublish">
<Year>2012</Year>
<Month>6</Month>
<Day>20</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2013</Year>
<Month>7</Month>
<Day>23</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed">
<Year>2013</Year>
<Month>7</Month>
<Day>23</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline">
<Year>2013</Year>
<Month>7</Month>
<Day>23</Day>
<Hour>6</Hour>
<Minute>1</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList>
<ArticleId IdType="doi">10.1007/s11420-012-9278-8</ArticleId>
<ArticleId IdType="pii">9278</ArticleId>
<ArticleId IdType="pubmed">23874253</ArticleId>
<ArticleId IdType="pmc">PMC3715624</ArticleId>
</ArticleIdList>
</PubmedData>
</PubmedArticle>
<PubmedArticle>
<MedlineCitation Owner="NLM" Status="MEDLINE">
<PMID Version="1">23194934</PMID>
<DateCreated>
<Year>2013</Year>
<Month>03</Month>
<Day>04</Day>
</DateCreated>
<DateCompleted>
<Year>2014</Year>
<Month>01</Month>
<Day>14</Day>
</DateCompleted>
<DateRevised>
<Year>2014</Year>
<Month>03</Month>
<Day>28</Day>
</DateRevised>
<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Electronic">1545-7206</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>54</Volume>
<Issue>2</Issue>
<PubDate>
<MedlineDate>2013 Mar-Apr</MedlineDate>
</PubDate>
</JournalIssue>
<Title>Psychosomatics</Title>
<ISOAbbreviation>Psychosomatics</ISOAbbreviation>
</Journal>
<ArticleTitle>Demographics and perioperative outcome in patients with depression and anxiety undergoing total joint arthroplasty: a population-based study.</ArticleTitle>
<Pagination>
<MedlinePgn>149-57</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.psym.2012.08.009</ELocationID>
<ELocationID EIdType="pii" ValidYN="Y">S0033-3182(12)00159-4</ELocationID>
<Abstract>
<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Depression and anxiety are highly prevalent psychiatric disorders. However, little is known about their impact on outcomes in the perioperative setting. This study is intended to gain insight into epidemiology and effects on perioperative morbidity, mortality, length of hospital stay, discharge and cost.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We obtained the National Inpatient Sample from the Hospital Cost and Utilization Project for each year between 2000 and 2008. Entries indicating the performance of primary total hip and knee arthroplasty were identified and separated into four groups: (1) those with concomitant diagnosis of depression or (2) anxiety, (3) both, and (4) none of these diagnoses. The incidence of major complications, non-routine discharge, length, and cost of hospitalization were assessed. Regression analysis was performed to identify if psychiatric comorbidity was an independent risk factor for each outcome.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">We identified 1,212,493 patients undergoing arthroplasty between 2000 and 2008. The prevalence of depression and anxiety significantly increased over time. Patients with either condition had higher hospital charges, rates of non-routine discharges and comorbidity index. Depression or anxiety were associated with significantly decreased adjusted odds for in-hospital mortality (OR = 0.53, p = 0.0147; OR = 0.58, p = 0.0064). The risk of developing a major complication was slightly lower in patients with depression, anxiety or both (OR=0.95, p = 0.0738; OR = 0.95, p = 0.0259; OR = 0.94, p = 0.7349).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Patients suffering from depression, anxiety, or both require more healthcare resources in a perioperative setting. However, lower short-term mortality in spite of higher comorbidity burden and without extensive changes in perioperative complication profile indicates better outcome for this group of patients.</AbstractText>
<CopyrightInformation>Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Stundner</LastName>
<ForeName>Ottokar</ForeName>
<Initials>O</Initials>
<Affiliation>Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA.</Affiliation>
</Author>
<Author ValidYN="Y">
<LastName>Kirksey</LastName>
<ForeName>Meghan</ForeName>
<Initials>M</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Chiu</LastName>
<ForeName>Ya Lin</ForeName>
<Initials>YL</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Mazumdar</LastName>
<ForeName>Madhu</ForeName>
<Initials>M</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Poultsides</LastName>
<ForeName>Lazaros</ForeName>
<Initials>L</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Gerner</LastName>
<ForeName>Peter</ForeName>
<Initials>P</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Memtsoudis</LastName>
<ForeName>Stavros G</ForeName>
<Initials>SG</Initials>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y">
<Grant>
<GrantID>U18 HS016-75</GrantID>
<Acronym>HS</Acronym>
<Agency>AHRQ HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>UL1 RR024996</GrantID>
<Acronym>RR</Acronym>
<Agency>NCRR NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>UL1-RR024996</GrantID>
<Acronym>RR</Acronym>
<Agency>NCRR NIH HHS</Agency>
<Country>United States</Country>
</Grant>
</GrantList>
<PublicationTypeList>
<PublicationType>Journal Article</PublicationType>
<PublicationType>Research Support, N.I.H., Extramural</PublicationType>
<PublicationType>Research Support, Non-U.S. Gov't</PublicationType>
<PublicationType>Research Support, U.S. Gov't, P.H.S.</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2012</Year>
<Month>11</Month>
<Day>27</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>England</Country>
<MedlineTA>Psychosomatics</MedlineTA>
<NlmUniqueID>0376506</NlmUniqueID>
<ISSNLinking>0033-3182</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Analysis of Variance</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Anxiety Disorders</DescriptorName>
<QualifierName MajorTopicYN="N">economics</QualifierName>
<QualifierName MajorTopicYN="Y">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Arthroplasty, Replacement</DescriptorName>
<QualifierName MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName MajorTopicYN="N">psychology</QualifierName>
<QualifierName MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Comorbidity</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Demography</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Depressive Disorder</DescriptorName>
<QualifierName MajorTopicYN="N">economics</QualifierName>
<QualifierName MajorTopicYN="Y">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Hospital Mortality</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Hospitalization</DescriptorName>
<QualifierName MajorTopicYN="Y">economics</QualifierName>
<QualifierName MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Logistic Models</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Odds Ratio</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Outcome Assessment (Health Care)</DescriptorName>
<QualifierName MajorTopicYN="N">economics</QualifierName>
<QualifierName MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Perioperative Period</DescriptorName>
<QualifierName MajorTopicYN="N">economics</QualifierName>
<QualifierName MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Postoperative Complications</DescriptorName>
<QualifierName MajorTopicYN="Y">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Prevalence</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N" Type="Geographic">United States</DescriptorName>
<QualifierName MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData>
<History>
<PubMedPubDate PubStatus="received">
<Year>2012</Year>
<Month>7</Month>
<Day>16</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised">
<Year>2012</Year>
<Month>8</Month>
<Day>17</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2012</Year>
<Month>8</Month>
<Day>20</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="aheadofprint">
<Year>2012</Year>
<Month>11</Month>
<Day>27</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2012</Year>
<Month>12</Month>
<Day>1</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed">
<Year>2012</Year>
<Month>12</Month>
<Day>1</Day>
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<ArticleId IdType="pii">S0033-3182(12)00159-4</ArticleId>
<ArticleId IdType="doi">10.1016/j.psym.2012.08.009</ArticleId>
<ArticleId IdType="pubmed">23194934</ArticleId>
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<MedlineCitation Owner="NLM" Status="MEDLINE">
<PMID Version="1">23091119</PMID>
<DateCreated>
<Year>2012</Year>
<Month>10</Month>
<Day>23</Day>
</DateCreated>
<DateCompleted>
<Year>2013</Year>
<Month>01</Month>
<Day>03</Day>
</DateCompleted>
<DateRevised>
<Year>2013</Year>
<Month>11</Month>
<Day>14</Day>
</DateRevised>
<Article PubModel="Print">
<Journal>
<ISSN IssnType="Electronic">1524-4628</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>43</Volume>
<Issue>11</Issue>
<PubDate>
<Year>2012</Year>
<Month>Nov</Month>
</PubDate>
</JournalIssue>
<Title>Stroke; a journal of cerebral circulation</Title>
<ISOAbbreviation>Stroke</ISOAbbreviation>
</Journal>
<ArticleTitle>Cerebrovascular reserve and stroke risk in patients with carotid stenosis or occlusion: a systematic review and meta-analysis.</ArticleTitle>
<Pagination>
<MedlinePgn>2884-91</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1161/STROKEAHA.112.663716</ELocationID>
<Abstract>
<AbstractText Label="BACKGROUND AND PURPOSE" NlmCategory="OBJECTIVE">Impairments in cerebrovascular reserve (CVR) have been variably associated with increased risk of ischemic events and may stratify stroke risk in patients with high-grade internal carotid artery stenosis or occlusion. The purpose of this study is to perform a systematic review and meta-analysis to summarize the association of CVR impairment and stroke risk.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We performed a literature search evaluating the association of impairments in CVR with future stroke or transient ischemic attack in patients with high-grade internal carotid artery stenosis or occlusion. We included studies with a minimum of 1-year patient follow-up with baseline CVR measures performed by any modality and primary outcome measures of stroke and/or transient ischemic attack. A meta-analysis with assessment of study heterogeneity and publication bias was performed. Results were presented in a forest plot and summarized using a random-effects model.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Thirteen studies met the inclusion criteria, representing a total of 1061 independent CVR tests in 991 unique patients with a mean follow-up of 32.7 months. We found a significant positive relationship between impairment of CVR and development of stroke with a pooled random effects OR of 3.86 (95% CI, 1.99-7.48). Subset analysis showed that this association between CVR impairment and future risk of stroke/transient ischemic attack remained significant regardless of ischemic outcome measure, symptomatic or asymptomatic disease, stenosis or occlusion, or CVR testing method.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">CVR impairment is strongly associated with increased risk of ischemic events in carotid stenosis or occlusion and may be useful for stroke risk stratification.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Gupta</LastName>
<ForeName>Ajay</ForeName>
<Initials>A</Initials>
<Affiliation>Department of Radiology, Weill Cornell Medical School, New York-Presbyterian Hospital, 525 East 68th Street, Starr 8A, Box 141, New York, NY 10065, USA. [email protected]</Affiliation>
</Author>
<Author ValidYN="Y">
<LastName>Chazen</LastName>
<ForeName>J Levi</ForeName>
<Initials>JL</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Hartman</LastName>
<ForeName>Maya</ForeName>
<Initials>M</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Delgado</LastName>
<ForeName>Diana</ForeName>
<Initials>D</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Anumula</LastName>
<ForeName>Nikesh</ForeName>
<Initials>N</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Shao</LastName>
<ForeName>Huibo</ForeName>
<Initials>H</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Mazumdar</LastName>
<ForeName>Madhu</ForeName>
<Initials>M</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Segal</LastName>
<ForeName>Alan Z</ForeName>
<Initials>AZ</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Kamel</LastName>
<ForeName>Hooman</ForeName>
<Initials>H</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Leifer</LastName>
<ForeName>Dana</ForeName>
<Initials>D</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Sanelli</LastName>
<ForeName>Pina C</ForeName>
<Initials>PC</Initials>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y">
<Grant>
<GrantID>RFA-HS-05-14</GrantID>
<Acronym>HS</Acronym>
<Agency>AHRQ HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>UL1 TR000457</GrantID>
<Acronym>TR</Acronym>
<Agency>NCATS NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>UL1 TR000457</GrantID>
<Acronym>TR</Acronym>
<Agency>NCATS NIH HHS</Agency>
<Country>United States</Country>
</Grant>
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<PublicationType>Journal Article</PublicationType>
<PublicationType>Meta-Analysis</PublicationType>
<PublicationType>Research Support, N.I.H., Extramural</PublicationType>
<PublicationType>Research Support, Non-U.S. Gov't</PublicationType>
<PublicationType>Research Support, U.S. Gov't, P.H.S.</PublicationType>
<PublicationType>Review</PublicationType>
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<QualifierName MajorTopicYN="Y">blood supply</QualifierName>
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<DescriptorName MajorTopicYN="N">Carotid Stenosis</DescriptorName>
<QualifierName MajorTopicYN="Y">complications</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="Y">Cerebrovascular Circulation</DescriptorName>
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<MeshHeading>
<DescriptorName MajorTopicYN="N">Cerebrovascular Disorders</DescriptorName>
<QualifierName MajorTopicYN="N">complications</QualifierName>
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<DescriptorName MajorTopicYN="N">Risk Factors</DescriptorName>
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<DescriptorName MajorTopicYN="N">Stroke</DescriptorName>
<QualifierName MajorTopicYN="Y">etiology</QualifierName>
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<ArticleId IdType="doi">10.1161/STROKEAHA.112.663716</ArticleId>
<ArticleId IdType="pubmed">23091119</ArticleId>
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<PMID Version="1">23080348</PMID>
<DateCreated>
<Year>2012</Year>
<Month>10</Month>
<Day>24</Day>
</DateCreated>
<DateCompleted>
<Year>2013</Year>
<Month>04</Month>
<Day>08</Day>
</DateCompleted>
<DateRevised>
<Year>2013</Year>
<Month>11</Month>
<Day>14</Day>
</DateRevised>
<Article PubModel="Print">
<Journal>
<ISSN IssnType="Electronic">1532-8651</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>37</Volume>
<Issue>6</Issue>
<PubDate>
<MedlineDate>2012 Nov-Dec</MedlineDate>
</PubDate>
</JournalIssue>
<Title>Regional anesthesia and pain medicine</Title>
<ISOAbbreviation>Reg Anesth Pain Med</ISOAbbreviation>
</Journal>
<ArticleTitle>Comparative perioperative outcomes associated with neuraxial versus general anesthesia for simultaneous bilateral total knee arthroplasty.</ArticleTitle>
<Pagination>
<MedlinePgn>638-44</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1097/AAP.0b013e31826e1494</ELocationID>
<Abstract>
<AbstractText Label="BACKGROUND AND OBJECTIVES" NlmCategory="OBJECTIVE">The influence of the type of anesthesia on perioperative outcomes after bilateral total knee arthroplasty (BTKA) remains unknown. Therefore, we examined a large sample of BTKA recipients, hypothesizing that neuraxial anesthesia would favorably impact on outcomes.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We identified patient entries indicating elective BTKA between 2006 and 2010 in a national database; subgrouped them by type of anesthesia: general (G), neuraxial (N), or combined neuraxial-general (NG); and analyzed differences in demographics and perioperative outcomes.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Of 15,687 identified procedures, 6.8% (n = 1066) were performed under N, 80.1% (n = 12,567) under G, and 13.1% (n = 2054) under NG. Comparing N to G and NG, patients in group N were, on average, younger (63.9, 64.6, and 64.8 years; P = 0.030) but did not differ in overall comorbidity burden. Patients in group N required blood product transfusions significantly less frequently (28.5%, 44.7%, 38.0%; P < 0.0001). In-hospital mortality, 30-day mortality, and complication rates tended to be lower in group N, without reaching statistical significance. After adjusting for covariates, N and NG were associated with 16.0% and 6.0% reduction in major complications compared with G, but only the reduced odds for the requirement of blood transfusions associated with N reached statistical significance (N vs G: odds ratio, 0.52 [95% CI, 0.45-0.61], P < 0.0001; NG vs G: odds ratio, 0.77 [95% CI, 0.69-0.86], P < 0.0001).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Neuraxial anesthesia for BTKA is associated with significantly lower rates of blood transfusions and, by trend, decreased morbidity. Although by itself the effect may be limited, N might be used within a multimodal approach to reduce complications after BTKA.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Stundner</LastName>
<ForeName>Ottokar</ForeName>
<Initials>O</Initials>
<Affiliation>Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, USA.</Affiliation>
</Author>
<Author ValidYN="Y">
<LastName>Chiu</LastName>
<ForeName>Ya-Lin</ForeName>
<Initials>YL</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Sun</LastName>
<ForeName>Xuming</ForeName>
<Initials>X</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Mazumdar</LastName>
<ForeName>Madhu</ForeName>
<Initials>M</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Fleischut</LastName>
<ForeName>Peter</ForeName>
<Initials>P</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Poultsides</LastName>
<ForeName>Lazaros</ForeName>
<Initials>L</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Gerner</LastName>
<ForeName>Peter</ForeName>
<Initials>P</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Fritsch</LastName>
<ForeName>Gerhard</ForeName>
<Initials>G</Initials>
</Author>
<Author ValidYN="Y">
<LastName>Memtsoudis</LastName>
<ForeName>Stavros G</ForeName>
<Initials>SG</Initials>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y">
<Grant>
<GrantID>U18 HSO16-75</GrantID>
<Agency>PHS HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>UL1 RR024996</GrantID>
<Acronym>RR</Acronym>
<Agency>NCRR NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>UL1-RR024996</GrantID>
<Acronym>RR</Acronym>
<Agency>NCRR NIH HHS</Agency>
<Country>United States</Country>
</Grant>
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<PublicationType>Journal Article</PublicationType>
<PublicationType>Research Support, N.I.H., Extramural</PublicationType>
<PublicationType>Research Support, Non-U.S. Gov't</PublicationType>
<PublicationType>Research Support, U.S. Gov't, P.H.S.</PublicationType>
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<MeshHeadingList>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Age Distribution</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="Y">Anesthesia, Epidural</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="Y">Anesthesia, General</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="Y">Anesthesia, Spinal</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="Y">Arthroplasty, Replacement, Knee</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Blood Transfusion</DescriptorName>
<QualifierName MajorTopicYN="N">utilization</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Databases, Factual</DescriptorName>
</MeshHeading>
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<DescriptorName MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading>
<DescriptorName MajorTopicYN="N">Hospital Mortality</DescriptorName>
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<DescriptorName MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName MajorTopicYN="N">Length of Stay</DescriptorName>
<QualifierName MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
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<DescriptorName MajorTopicYN="N">Male</DescriptorName>
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<MeshHeading>
<DescriptorName MajorTopicYN="N">Middle Aged</DescriptorName>
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<MeshHeading>
<DescriptorName MajorTopicYN="N">Multivariate Analysis</DescriptorName>
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<MeshHeading>
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