Outcomes After Hypotensive Neuraxial Anesthesia in Total Hip Arthroplasty

Study Overview
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Brief Summary
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This is a retrospective chart review to determine if neuraxial anesthesia is associated with worse outcomes after Primary Total Hip Arthroplasty.

Detailed Description
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The goal of this study is to determine if hypotensive neuraxial anesthesia is associated with worse outcomes in Primary Total Hip Arthroplasty. The plan to analyze the outcomes is listed below: Primary outcomes: Multiple logistic regression will be used to compute the adjusted odds ratios of any postoperative complications (MI, CVA, death) , adjusting for covariates including duration of intraoperative mean arterial pressure of less than pre-defined threshold, such as 55, or 60 mmHg mean blood pressure. Sensitivity analyses will also consider the effects of intra-operative hypotension (IOH) defined as mean blood pressure of less than 40, 45, 50, 55, 60, and 65 mm Hg. Secondary outcomes: Multiple logistic regression will be to compute the adjusted odds ratios of individual postoperative complications, (such as MI, CVA, stroke) , adjusting for covariates including duration of intraoperative mean blood pressure of less than pre-defined threshold, such as 55, or 60 mmHg mean blood pressure. Sensitivity analyses will also be conducted to test the effects of extend of IOH on complications.

Official Title
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Outcomes After Hypotensive Neuraxial Anesthesia in Total Hip Arthroplasty

Conditions
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Total Hip Arthroplasty, Primary Total Hip Arthroplasty, Hypotension, Database

Intervention / Treatment
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* Other: Chart Review


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All primary total hip arthroplasty patient data with sufficiently complete intraoperative vital signs Exclusion Criteria: Revision primary total hip arthroplasty Incomplete intraoperative vital signs Anterior total hip arthroplasty

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Primary Total Hip Arthroplasty<br>This is a chart review to determine if hypotensive neuraxial anesthesia is associated with worse outcomes in Primary Total Hip Arthroplasty | Other: Chart Review<br>* This is a chart review to determine if hypotensive neuraxial anesthesia is associated with worse outcomes in Primary Total Hip Arthroplasty patients.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite Outcome | The association between levels and length of intraoperative controlled hypotension and incidence rates of individual and composite outcome of any of the following events: (i) myocardial infarction (MI), (ii) cerebrovascular accident (CVA), (iii) death. If any of these events are positive, then the composite outcome will be positive. The units of measurement will be the same. | Day of Surgery (Day 0) through discharge, average of 2 days |