The Journal of arthroplasty · 2025
Real-World Impact of Treatment With Liposomal Bupivacaine on Health Care Resource Utilization, Opioid Consumption, and Cost Among Patients Undergoing Total Knee Arthroplasty in Ambulatory Surgical Settings in the United States.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lin Jennifer H, Huo Tianyao, Pandya Shivani, Mont Michael A, Ng Mitchell K, Wong Gabriel, Zhou Zifan, DeKoven Mitch, DiGiorgi Mary, Pizzicato Lia
Аннотация
BACKGROUND: Perioperative pain management is critical to postsurgical recovery, as inadequate control can adversely affect patients for years. With the rise of total knee arthroplasty (TKA) in ambulatory surgery centers (ASCs), evaluating real-world strategies for postoperative analgesia has become increasingly important. The aims of this study were to (1) compare postoperative opioid use between patients receiving liposomal bupivacaine (LB) versus those who did not; (2) evaluate LB's effect on outpatient physical therapy visits and health care utilization; and (3) quantify differences in pain-related health care costs.
METHODS: Patients undergoing TKA in an outpatient ASC with moderate-to-high volume LB use between January 2019 and November 2022 were retrospectively identified from a national database. Patients were placed into two cohorts based on LB use on the TKA procedure date. Propensity score matching (PSM) with 1:1 matching created balanced cohorts. After PSM, each cohort comprised 2,307 patients (mean age of 69 years; 60.3% women). Opioid usage, all-cause and pain-related health care resource utilization (HCRU), and costs were examined over 30, 90, and 360 days postsurgery.
RESULTS: On average, patients treated with LB had fewer opioid-treated days over 360 days postsurgery than those who did not have LB (35.2 versus 30.4; P < 0.05). Patients who had LB had fewer all-cause physical and occupational therapy (PT/OT) visits than patients who did not have LB over 30 (3.0 versus 3.5, P < 0.01), 90 (7.1 versus 8.1, P < 0.01), and 360 days (10.1 versus 11.6, P < 0.01) postsurgery, with consistent trends for pain-related PT/OT visits (all P < 0.01). Patients with LB incurred significantly lower total health care costs of $247, $438, and $1,318 less over 30, 90, and 360 days postsurgery, respectively, with similar trends for pain-related costs (all P < 0.05).
CONCLUSIONS: Postsurgical LB analgesia was associated with fewer opioid-treated days and lower total HCRU and costs over one year after surgery. These results may further inform health care providers of the role of LB analgesia as part of multimodal pain management in improving postsurgical care following TKA in ASCs.
METHODS: Patients undergoing TKA in an outpatient ASC with moderate-to-high volume LB use between January 2019 and November 2022 were retrospectively identified from a national database. Patients were placed into two cohorts based on LB use on the TKA procedure date. Propensity score matching (PSM) with 1:1 matching created balanced cohorts. After PSM, each cohort comprised 2,307 patients (mean age of 69 years; 60.3% women). Opioid usage, all-cause and pain-related health care resource utilization (HCRU), and costs were examined over 30, 90, and 360 days postsurgery.
RESULTS: On average, patients treated with LB had fewer opioid-treated days over 360 days postsurgery than those who did not have LB (35.2 versus 30.4; P < 0.05). Patients who had LB had fewer all-cause physical and occupational therapy (PT/OT) visits than patients who did not have LB over 30 (3.0 versus 3.5, P < 0.01), 90 (7.1 versus 8.1, P < 0.01), and 360 days (10.1 versus 11.6, P < 0.01) postsurgery, with consistent trends for pain-related PT/OT visits (all P < 0.01). Patients with LB incurred significantly lower total health care costs of $247, $438, and $1,318 less over 30, 90, and 360 days postsurgery, respectively, with similar trends for pain-related costs (all P < 0.05).
CONCLUSIONS: Postsurgical LB analgesia was associated with fewer opioid-treated days and lower total HCRU and costs over one year after surgery. These results may further inform health care providers of the role of LB analgesia as part of multimodal pain management in improving postsurgical care following TKA in ASCs.