Searched for: person:mhm7
Long-term outcomes with spinal versus general anesthesia for hip fracture surgery: A randomized trial
Vail, Emily A; Feng, Rui; Sieber, Frederick; Carson, Jeffrey L; Ellenberg, Susan S; Magaziner, Jay; Dillane, Derek; Marcantonio, Edward R; Sessler, Daniel I; Ayad, Sabry; Stone, Trevor; Papp, Steven; Donegan, Derek; Mehta, Samir; Schwenk, Eric S; Marshall, Mitchell; Jaffe, J Douglas; Luke, Charles; Sharma, Balram; Azim, Syed; Hymes, Robert; Chin, Ki-Jinn; Sheppard, Richard; Perlman, Barry; Sappenfield, Joshua; Hauck, Ellen; Tierney, Ann; Horan, Annamarie D; Neuman, Mark D; ,
BACKGROUND:The effects of spinal versus general anesthesia on long-term outcomes have not been well-studied. We tested the hypothesis that spinal anesthesia is associated with better long-term survival and functional recovery than general anesthesia. METHODS:We conducted a pre-specified analysis of long-term outcomes of a completed randomized superiority trial that compared spinal anesthesia versus general anesthesia for hip fracture repair. Participants included previously ambulatory patients 50 years of age or older at 46 US and Canadian hospitals. Patients were randomized 1:1 to spinal or general anesthesia, stratified by sex, fracture type, and study site. Outcome assessors and investigators involved in the data analysis were masked to the treatment arm. Outcomes included survival at up to 365 days after randomization (primary); recovery of ambulation among 365-day survivors; and composite endpoints for death or new inability to ambulate and death or new nursing home residence at 365 days. Patients were included in the analysis as randomized. RESULTS:1,600 patients were enrolled between February 12, 2016, and February 18, 2021; 795 were assigned to spinal anesthesia, and 805 were assigned to general anesthesia. Among 1,599 patients who underwent surgery, vital status information at or beyond the final study interview (conducted at approximately 365 days after randomization) was available for 1,427 (89.2%). Survival did not differ by treatment arm; at 365 days after randomization, there were 98 deaths in patients assigned to spinal anesthesia versus 92 deaths in patients assigned to general anesthesia (hazard ratio: 1.08; 95% confidence interval (CI): 0.81, 1.44, P=0.59). Recovery of ambulation among patients who survived a year did not differ by type of anesthesia (adjusted odds ratio, spinal vs. general: 0.87; 95% CI: 0.67, 1.14, P=0.31). Other outcomes did not differ by treatment arm. CONCLUSIONS:Long-term outcomes were similar with spinal versus general anesthesia.
PMID: 37831596
ISSN: 1528-1175
CID: 5604212
Outcomes with spinal versus general anesthesia for patients with and without preoperative cognitive impairment: Secondary analysis of a randomized clinical trial
O'Brien, Kyra; Feng, Rui; Sieber, Frederick; Marcantonio, Edward R; Tierney, Ann; Magaziner, Jay; Carson, Jeffrey L; Dillane, Derek; Sessler, Daniel I; Menio, Diane; Ayad, Sabry; Stone, Trevor; Papp, Steven; Schwenk, Eric S; Marshall, Mitchell; Jaffe, J Douglas; Luke, Charles; Sharma, Balram; Azim, Syed; Hymes, Robert; Chin, Ki-Jinn; Sheppard, Richard; Perlman, Barry; Sappenfield, Joshua; Hauck, Ellen; Hoeft, Mark A; Karlawish, Jason; Mehta, Samir; Donegan, Derek J; Horan, Annamarie; Ellenberg, Susan S; Neuman, Mark D
INTRODUCTION/BACKGROUND:The effect of spinal versus general anesthesia on the risk of postoperative delirium or other outcomes for patients with or without cognitive impairment (including dementia) is unknown. METHODS:Post hoc secondary analysis of a multicenter pragmatic trial comparing spinal versus general anesthesia for adults aged 50 years or older undergoing hip fracture surgery. RESULTS:Among patients randomized to spinal versus general anesthesia, new or worsened delirium occurred in 100/295 (33.9%) versus 107/283 (37.8%; odds ratio [OR] 0.85; 95% confidence interval [CI] 0.60 to 1.19) among persons with cognitive impairment and 70/432 (16.2%) versus 71/445 (16.0%) among persons without cognitive impairment (OR 1.02; 95% CI 0.71 to 1.47, p = 0.46 for interaction). Delirium severity, in-hospital complications, and 60-day functional recovery did not differ by anesthesia type in patients with or without cognitive impairment. DISCUSSION/CONCLUSIONS:Anesthesia type is not associated with differences in delirium and functional outcomes among persons with or without cognitive impairment.
PMID: 37170754
ISSN: 1552-5279
CID: 5509442
Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial
Neuman, Mark D; Feng, Rui; Ellenberg, Susan S; Sieber, Frederick; Sessler, Daniel I; Magaziner, Jay; Elkassabany, Nabil; Schwenk, Eric S; Dillane, Derek; Marcantonio, Edward R; Menio, Diane; Ayad, Sabry; Hassan, Manal; Stone, Trevor; Papp, Steven; Donegan, Derek; Marshall, Mitchell; Jaffe, J Douglas; Luke, Charles; Sharma, Balram; Azim, Syed; Hymes, Robert; Chin, Ki-Jinn; Sheppard, Richard; Perlman, Barry; Sappenfield, Joshua; Hauck, Ellen; Hoeft, Mark A; Tierney, Ann; Gaskins, Lakisha J; Horan, Annamarie D; Brown, Trina; Dattilo, James; Carson, Jeffrey L; Looke, Thomas; Bent, Sandra; Franco-Mora, Ariana; Hedrick, Pamela; Newbern, Matthew; Tadros, Rafik; Pealer, Karen; Vlassakov, Kamen; Buckley, Carolyn; Gavin, Lauren; Gorbatov, Svetlana; Gosnell, James; Steen, Talora; Vafai, Avery; Zeballos, Jose; Hruslinski, Jennifer; Cardenas, Louis; Berry, Ashley; Getchell, John; Quercetti, Nicholas; Bajracharya, Gauasan; Billow, Damien; Bloomfield, Michael; Cuko, Evis; Elyaderani, Mehrun K; Hampton, Robert; Honar, Hooman; Khoshknabi, Dilara; Kim, Daniel; Krahe, David; Lew, Michael M; Maheshwer, Conjeevram B; Niazi, Azfar; Saha, Partha; Salih, Ahmed; de Swart, Robert J; Volio, Andrew; Bolkus, Kelly; DeAngelis, Matthew; Dodson, Gregory; Gerritsen, Jeffrey; McEniry, Brian; Mitrev, Ludmil; Kwofie, M Kwesi; Belliveau, Anne; Bonazza, Flynn; Lloyd, Vera; Panek, Izabela; Dabiri, Jared; Chavez, Chris; Craig, Jason; Davidson, Todd; Dietrichs, Chad; Fleetwood, Cheryl; Foley, Mike; Getto, Chris; Hailes, Susie; Hermes, Sarah; Hooper, Andy; Koener, Greg; Kohls, Kate; Law, Leslie; Lipp, Adam; Losey, Allison; Nelson, William; Nieto, Mario; Rogers, Pam; Rutman, Steve; Scales, Garrett; Sebastian, Barbara; Stanciu, Tom; Lobel, Gregg; Giampiccolo, Michelle; Herman, Dara; Kaufman, Margit; Murphy, Bryan; Pau, Clara; Puzio, Thomas; Veselsky, Marlene; Apostle, Kelly; Boyer, Dory; Fan, Brenda Chen; Lee, Susan; Lemke, Mike; Merchant, Richard; Moola, Farhad; Payne, Kyrsten; Perey, Bertrand; Viskontas, Darius; Poler, Mark; D'Antonio, Patricia; O'Neill, Greg; Abdullah, Amer; Fish-Fuhrmann, Jamie; Giska, Mark; Fidkowski, Christina; Guthrie, Stuart Trent; Hakeos, William; Hayes, Lillian; Hoegler, Joseph; Nowak, Katherine; Beck, Jeffery; Cuff, Jaslynn; Gaski, Greg; Haaser, Sharon; Holzman, Michael; Malekzadeh, A Stephen; Ramsey, Lolita; Schulman, Jeff; Schwartzbach, Cary; Azefor, Tangwan; Davani, Arman; Jaberi, Mahmood; Masear, Courtney; Haider, Syed Basit; Chungu, Carolyn; Ebrahimi, Ali; Fikry, Karim; Marcantonio, Andrew; Shelvan, Anitha; Sanders, David; Clarke, Collin; Lawendy, Abdel; Schwartz, Gary; Garg, Mohit; Kim, Joseph; Caruci, Juan; Commeh, Ekow; Cuevas, Randy; Cuff, Germaine; Franco, Lola; Furgiuele, David; Giuca, Matthew; Allman, Melissa; Barzideh, Omid; Cossaro, James; D'Arduini, Armando; Farhi, Anita; Gould, Jason; Kafel, John; Patel, Anuj; Peller, Abraham; Reshef, Hadas; Safur, Mohammed; Toscano, Fiore; Tedore, Tiffany; Akerman, Michael; Brumberger, Eric; Clark, Sunday; Friedlander, Rachel; Jegarl, Anita; Lane, Joseph; Lyden, John P; Mehta, Nili; Murrell, Matthew T; Painter, Nathan; Ricci, William; Sbrollini, Kaitlyn; Sharma, Rahul; Steel, Peter A D; Steinkamp, Michele; Weinberg, Roniel; Wellman, David Stephenson; Nader, Antoun; Fitzgerald, Paul; Ritz, Michaela; Bryson, Greg; Craig, Alexandra; Farhat, Cassandra; Gammon, Braden; Gofton, Wade; Harris, Nicole; Lalonde, Karl; Liew, Allan; Meulenkamp, Bradley; Sonnenburg, Kendra; Wai, Eugene; Wilkin, Geoffrey; Troxell, Karen; Alderfer, Mary Ellen; Brannen, Jason; Cupitt, Christopher; Gerhart, Stacy; McLin, Renee; Sheidy, Julie; Yurick, Katherine; Chen, Fei; Dragert, Karen; Kiss, Geza; Malveaux, Halina; McCloskey, Deborah; Mellender, Scott; Mungekar, Sagar S; Noveck, Helaine; Sagebien, Carlos; Biby, Luat; McKelvy, Gail; Richards, Anna; Abola, Ramon; Ayala, Brittney; Halper, Darcy; Mavarez, Ana; Rizwan, Sabeen; Choi, Stephen; Awad, Imad; Flynn, Brendan; Henry, Patrick; Jenkinson, Richard; Kaustov, Lilia; Lappin, Elizabeth; McHardy, Paul; Singh, Amara; Donnelly, Joanne; Gonzalez, Meera; Haydel, Christopher; Livelsberger, Jon; Pazionis, Theresa; Slattery, Bridget; Vazquez-Trejo, Maritza; Baratta, Jaime; Cirullo, Michael; Deiling, Brittany; Deschamps, Laura; Glick, Michael; Katz, Daniel; Krieg, James; Lessin, Jennifer; Mojica, Jeffrey; Torjman, Marc; Jin, Rongyu; Salpeter, Mary Jane; Powell, Mark; Simmons, Jeffrey; Lawson, Prentiss; Kukreja, Promil; Graves, Shanna; Sturdivant, Adam; Bryant, Ayesha; Crump, Sandra Joyce; Verrier, Michelle; Green, James; Menon, Matthew; Applegate, Richard; Arias, Ana; Pineiro, Natasha; Uppington, Jeffrey; Wolinsky, Phillip; Gunnett, Amy; Hagen, Jennifer; Harris, Sara; Hollen, Kevin; Holloway, Brian; Horodyski, Mary Beth; Pogue, Trevor; Ramani, Ramachandran; Smith, Cameron; Woods, Anna; Warrick, Matthew; Flynn, Kelly; Mongan, Paul; Ranganath, Yatish; Fernholz, Sean; Ingersoll-Weng, Esperanza; Marian, Anil; Seering, Melinda; Sibenaller, Zita; Stout, Lori; Wagner, Allison; Walter, Alicia; Wong, Cynthia; Orwig, Denise; Goud, Maithri; Helker, Chris; Mezenghie, Lydia; Montgomery, Brittany; Preston, Peter; Schwartz, J Sanford; Weber, Ramona; Fleisher, Lee A; Mehta, Samir; Stephens-Shields, Alisa J; Dinh, Cassandra; Chelly, Jacques E; Goel, Shiv; Goncz, Wende; Kawabe, Touichi; Khetarpal, Sharad; Monroe, Amy; Shick, Vladislav; Breidenstein, Max; Dominick, Timothy; Friend, Alexander; Mathews, Donald; Lennertz, Richard; Sanders, Robert; Akere, Helen; Balweg, Tyler; Bo, Amber; Doro, Christopher; Goodspeed, David; Lang, Gerald; Parker, Maggie; Rettammel, Amy; Roth, Mary; White, Marissa; Whiting, Paul; Allen, Brian F S; Baker, Tracie; Craven, Debra; McEvoy, Matt; Turnbo, Teresa; Kates, Stephen; Morgan, Melanie; Willoughby, Teresa; Weigel, Wade; Auyong, David; Fox, Ellie; Welsh, Tina; Cusson, Bruce; Dobson, Sean; Edwards, Christopher; Harris, Lynette; Henshaw, Daryl; Johnson, Kathleen; McKinney, Glen; Miller, Scott; Reynolds, Jon; Segal, B Scott; Turner, Jimmy; VanEenenaam, David; Weller, Robert; Lei, Jineli; Treggiari, Miriam; Akhtar, Shamsuddin; Blessing, Marcelle; Johnson, Chanel; Kampp, Michael; Kunze, Kimberly; O'Connor, Mary; Looke, Thomas; Tadros, Rafik; Vlassakov, Kamen; Cardenas, Louis; Bolkus, Kelly; Mitrev, Ludmil; Kwofie, M Kwesi; Dabiri, Jared; Lobel, Gregg; Poler, Mark; Giska, Mark; Sanders, David; Schwartz, Gary; Giuca, Matthew; Tedore, Tiffany; Nader, Antoun; Bryson, Greg; Troxell, Karen; Kiss, Geza; Choi, Stephen; Powell, Mark; Applegate, Richard; Warrick, Matthew; Ranganath, Yatish; Chelly, Jacques E; Lennertz, Richard; Sanders, Robert; Allen, Brian F S; Kates, Stephen; Weigel, Wade; Li, Jinlei; Wijeysundera, Duminda N; Kheterpal, Sachin; Moore, Reneé H; Smith, Alexander K; Tosi, Laura L; Looke, Thomas; Mehta, Samir; Fleisher, Lee; Hruslinski, Jennifer; Ramsey, Lolita; Langlois, Christine; Mezenghie, Lydia; Montgomery, Brittany; Oduwole, Samuel; Rose, Thomas
BACKGROUND:The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported. OBJECTIVE:To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia. DESIGN:Preplanned secondary analysis of a pragmatic randomized trial. (ClinicalTrials.gov: NCT02507505). SETTING:46 U.S. and Canadian hospitals. PARTICIPANTS:Patients aged 50 years or older undergoing hip fracture surgery. INTERVENTION:Spinal or general anesthesia. MEASUREMENTS:Pain on postoperative days 1 through 3; 60-, 180-, and 365-day pain and prescription analgesic use; and satisfaction with care. RESULTS:A total of 1600 patients were enrolled. The average age was 78 years, and 77% were women. A total of 73.5% (1050 of 1428) of patients reported severe pain during the first 24 hours after surgery. Worst pain over the first 24 hours after surgery was greater with spinal anesthesia (rated from 0 [no pain] to 10 [worst pain imaginable]; mean difference, 0.40 [95% CI, 0.12 to 0.68]). Pain did not differ across groups at other time points. Prescription analgesic use at 60 days occurred in 25% (141 of 563) and 18.8% (108 of 574) of patients assigned to spinal and general anesthesia, respectively (relative risk, 1.33 [CI, 1.06 to 1.65]). Satisfaction was similar across groups. LIMITATION:Missing outcome data and multiple outcomes assessed. CONCLUSION:Severe pain is common after hip fracture. Spinal anesthesia was associated with more pain in the first 24 hours after surgery and more prescription analgesic use at 60 days compared with general anesthesia. PRIMARY FUNDING SOURCE:
PMID: 35696684
ISSN: 1539-3704
CID: 5277802
Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults
Neuman, Mark D; Feng, Rui; Carson, Jeffrey L; Gaskins, Lakisha J; Dillane, Derek; Sessler, Daniel I; Sieber, Frederick; Magaziner, Jay; Marcantonio, Edward R; Mehta, Samir; Menio, Diane; Ayad, Sabry; Stone, Trevor; Papp, Steven; Schwenk, Eric S; Elkassabany, Nabil; Marshall, Mitchell; Jaffe, J Douglas; Luke, Charles; Sharma, Balram; Azim, Syed; Hymes, Robert A; Chin, Ki-Jinn; Sheppard, Richard; Perlman, Barry; Sappenfield, Joshua; Hauck, Ellen; Hoeft, Mark A; Giska, Mark; Ranganath, Yatish; Tedore, Tiffany; Choi, Stephen; Li, Jinlei; Kwofie, M Kwesi; Nader, Antoun; Sanders, Robert D; Allen, Brian F S; Vlassakov, Kamen; Kates, Stephen; Fleisher, Lee A; Dattilo, James; Tierney, Ann; Stephens-Shields, Alisa J; Ellenberg, Susan S
BACKGROUND:The effects of spinal anesthesia as compared with general anesthesia on the ability to walk in older adults undergoing surgery for hip fracture have not been well studied. METHODS:We conducted a pragmatic, randomized superiority trial to evaluate spinal anesthesia as compared with general anesthesia in previously ambulatory patients 50 years of age or older who were undergoing surgery for hip fracture at 46 U.S. and Canadian hospitals. Patients were randomly assigned in a 1:1 ratio to receive spinal or general anesthesia. The primary outcome was a composite of death or an inability to walk approximately 10 ft (3 m) independently or with a walker or cane at 60 days after randomization. Secondary outcomes included death within 60 days, delirium, time to discharge, and ambulation at 60 days. RESULTS:A total of 1600 patients were enrolled; 795 were assigned to receive spinal anesthesia and 805 to receive general anesthesia. The mean age was 78 years, and 67.0% of the patients were women. A total of 666 patients (83.8%) assigned to spinal anesthesia and 769 patients (95.5%) assigned to general anesthesia received their assigned anesthesia. Among patients in the modified intention-to-treat population for whom data were available, the composite primary outcome occurred in 132 of 712 patients (18.5%) in the spinal anesthesia group and 132 of 733 (18.0%) in the general anesthesia group (relative risk, 1.03; 95% confidence interval [CI], 0.84 to 1.27; P = 0.83). An inability to walk independently at 60 days was reported in 104 of 684 patients (15.2%) and 101 of 702 patients (14.4%), respectively (relative risk, 1.06; 95% CI, 0.82 to 1.36), and death within 60 days occurred in 30 of 768 (3.9%) and 32 of 784 (4.1%), respectively (relative risk, 0.97; 95% CI, 0.59 to 1.57). Delirium occurred in 130 of 633 patients (20.5%) in the spinal anesthesia group and in 124 of 629 (19.7%) in the general anesthesia group (relative risk, 1.04; 95% CI, 0.84 to 1.30). CONCLUSIONS:Spinal anesthesia for hip-fracture surgery in older adults was not superior to general anesthesia with respect to survival and recovery of ambulation at 60 days. The incidence of postoperative delirium was similar with the two types of anesthesia. (Funded by the Patient-Centered Outcomes Research Institute; REGAIN ClinicalTrials.gov number, NCT02507505.).
PMID: 34623788
ISSN: 1533-4406
CID: 5077372
Engaging patients as partners in a multicentre trial of spinal versus general anaesthesia for older adults
Hruslinski, Jennifer; Menio, Diane A; Hymes, Robert A; Jaffe, J Douglas; Langlois, Christine; Ramsey, Lolita; Gaskins, Lakisha J; Neuman, Mark D; Looke, Thomas; Bent, Sandra; Franco-Mora, Ariana; Hedrick, Pamela; Newbern, Matthew; Tadros, Rafik; Pealer, Karen; Marcantonio, Edward; Vlassakov, Kamen; Buckley, Carolyn; Gorbatov, Svetlana; Gosnell, James; Steen, Talora; Vafai, Avery; Zeballos, Jose; Cardenas, Louis; Berry, Ashley; Getchell, John; Quercetti, Nicholas; Sessler, Daniel I; Ayad, Sabry; Hassan, Manal; Ali, Assad; Bajracharya, Gauasan; Billow, Damien; Bloomfield, Michael; Elliott, Kavita; Hampton, Robert; He, Linda; Honar, Hooman; Khoshknabi, Dilara; Kim, Daniel; Minko, Paul; Morris, Adam; Niazi, Azfar; Nutcharoen, Tara; Roberts, Jeffrey; Saha, Partha; Salih, Ahmed; Skolaris, Alexis; Stang, Taylor; Strimbu, Victor; Templeton, Jesse; Volio, Andrew; Wang, Jiayi; Bolkus, Kelly; DeAngelis, Matthew; Dodson, Gregory; Gerritsen, Jeffrey; McEniry, Brian; Mitrev, Ludmil; Kwofie, Kwesi; Bonazza, Flynn; Lloyd, Vera; Panek, Izabela; Dabiri, Jared; Chavez, Chris; Craig, Jason; Davidson, Todd; Dietrichs, Chad; Fleetwood, Cheryl; Foley, Mike; Getto, Chris; Hailes, Susie; Hermes, Sarah; Hooper, Andy; Koener, Greg; Kohls, Kate; Law, Leslie; Lipp, Adam; Losey, Allison; Nelson, William; Nieto, Mario; Rogers, Pam; Rutman, Steve; Scales, Garrett; Sebastian, Barbara; Stanciu, Tom; Lobel, Gregg; Giampiccolo, Michelle; Herman, Dara; Kaufman, Margit; Murphy, Bryan; Pau, Clara; Puzio, Thomas; Veselsky, Marlene; Stone, Trevor; Apostle, Kelly; Boyer, Dory; Fan, Brenda Chen; Lee, Susan; Lemke, Mike; Merchant, Richard; Moola, Farhad; Payne, Kyrsten; Perey, Bertrand; Viskontas, Darius; Poler, Mark; D'Antonio, Patricia; Sheppard, Richard; Abdullah, Amer; Fish-Fuhrmann, Jamie; Giska, Mark; Fidkowski, Christina; Guthrie, Trent; Hakeos, William; Hayes, Lillian; Hoegler, Joseph; Nowak, Katherine; Hymes, Robert; Beck, Jeffery; Cuff, Jaslynn; Gaski, Greg; Haaser, Sharon; Holzman, Michael; Malekzadeh, A Stephen; Ramsey, Lolita; Schulman, Jeff; Schwartzbach, Cary; Sieber, Frederick; Azefor, Tangwan; Brown, Charles; Davani, Arman; Jaberi, Mahmood; Masear, Courtney; Sharma, Balram; Haider, Syed Basit; Chungu, Carolyn; Ebrahimi, Ali; Fikry, Karim; Gannon, Kerri; Marcantonio, Andrew; Pace, Meredith; Sanders, David; Clarke, Collin; Lawendy, Abdel; Schwartz, Gary; Garg, Mohit; Kim, Joseph; Marshall, Mitchell; Caurci, Juan; Commeh, Ekow; Cuevas, Randy; Cuff, Germaine; Franco, Lola; Furguiele, David; Giuca, Matthew; Allman, Melissa; Barzideh, Omid; Cossaro, James; D'Arduini, Armando; Farhi, Anita; Gould, Jason; Kafel, John; Patel, Anuj; Peller, Abraham; Reshef, Hadas; Safur, Mohammed; Toscano, Fiore; Tedore, Tiffany; Akerman, Michael; Brumberger, Eric; Clark, Sunday; Friedlander, Rachel; Jegarl, Anita; Lane, Joseph; Lyden, John P; Mehta, Nili; Murrell, Matthew T; Painter, Nathan; Ricci, William; Sbrollini, Kaitlyn; Sharma, Rahul; Steel, Peter A D; Steinkamp, Michele; Weinberg, Roniel; Wellman, David Stephenson; Nader, Antoun; Fitzgerald, Paul; Ritz, Michaela; Papp, Steven; Bryson, Greg; Craig, Alexandra; Farhat, Cassandra; Gammon, Braden; Gofton, Wade; Harris, Nicole; Lalonde, Karl; Liew, Allan; Meulenkamp, Bradley; Sonnenburg, Kendra; Wai, Eugene; Wilkin, Geoffrey; Donegan, Derek; Dinh, Cassandra; Elkassabany, Nabil; Horan, Annamarie; Mehta, Samir; Troxell, Karen; Alderfer, Mary Ellen; Brannen, Jason; Cupitt, Christopher; Gerhart, Stacy; McLin, Renee; Sheidy, Julie; Yurick, Katherine; Carson, Jeffrey; Chen, Fei; Dragert, Karen; Kiss, Geza; Malveaux, Halina; McCloskey, Deborah; Mellender, Scott; Mungekar, Sagar S; Noveck, Helaine; Sagebien, Carlos; Perlman, Barry; Biby, Luat; McKelvy, Gail; Richards, Anna; Azim, Syed; Abola, Ramon; Ayala, Brittney; Halper, Darcy; Mavarez, Ana; Choi, Stephen; Awad, Imad; Flynn, Brendan; Henry, Patrick; Jenkinson, Richard; Kaustov, Lilia; Lappin, Elizabeth; McHardy, Paul; Singh, Amara; Hauck, Ellen; Donnelly, Joanne; Gonzalez, Meera; Haydel, Christopher; Livelsberger, Jon; Pazionis, Theresa; Slattery, Bridget; Vazquez-Trejo, Maritza; Schwenk, Eric; Baratta, Jaime; Deiling, Brittany; Deschamps, Laura; Glick, Michael; Katz, Daniel; Krieg, James; Lessin, Jennifer; Torjman, Marc; Chin, Ki Jinn; Jin, Rongyu; Salpeter, Mary Jane; Powell, Mark; Simmons, Jeffrey; Lawson, Prentiss; Kukreja, Promil; Graves, Shanna; Sturdivant, Adam; Bryant, Ayesha; Crump, Sandra Joyce; Dillane, Derek; Taylor, Michael; Verrier, Michelle; Applegate, Richard; Arias, Ana; Pineiro, Natasha; Uppington, Jeffrey; Wolinsky, Phillip; Sappenfield, Joshua; Gunnett, Amy; Hagen, Jennifer; Harris, Sara; Hollen, Kevin; Holloway, Brian; Horodyski, Mary Beth; Pogue, Trevor; Ramani, Ramachandran; Smith, Cameron; Woods, Anna; Warrick, Matthew; Flynn, Kelly; Mongan, Paul; Ranganath, Yatish; Fernholz, Sean; Ingersoll-Weng, Esperanza; Marian, Anil; Seering, Melinda; Sibenaller, Zita; Stout, Lori; Wagner, Allison; Walter, Alicia; Wong, Cynthia; Magaziner, Jay; Orwig, Denise; Brown, Trina; Dattilo, Jim; Ellenberg, Susan; Feng, Rui; Fleisher, Lee; Gaskins, Lakisha; Goud, Maithri; Helker, Chris; Mezenghie, Lydia; Montgomery, Brittany; Preston, Peter; Stephens, Alisa; Schwartz, J Sanford; Tierney, Ann; Weber, Ramona; Chelly, Jacques; Goel, Shiv; Goncz, Wende; Kawabe, Touichi; Khetarpal, Sharad; King, Kevin; Kunkel, Frank; Luke, Charles; Monroe, Amy; Shick, Vladislav; Silipo, Anthony; Stehle, Caroline; Szabo, Katherine; Yennam, Sudhakar; Hoeft, Mark; Breidenstein, Max; Dominick, Timothy; Friend, Alexander; Mathews, Donald; Lennertz, Richard; Akere, Helen; Balweg, Tyler; Bo, Amber; Doro, Christopher; Goodspeed, David; Lang, Gerald; Parker, Maggie; Rettammel, Amy; Roth, Mary; Sanders, Robert; White, Marissa; Whiting, Paul; Allen, Brian; Baker, Tracie; Craven, Debra; McEvoy, Matt; Turnbo, Teresa; Kates, Stephen; Morgan, Melanie; Willoughby, Teresa; Weigel, Wade; Auyong, David; Fox, Ellie; Welsh, Tina; Jaffe, J Douglas; Cusson, Bruce; Dobson, Sean; Edwards, Christopher; Harris, Lynette; Henshaw, Daryl; Johnson, Kathleen; McKinney, Glen; Miller, Scott; Reynolds, Jon; Turner, Jimmy; VanEenenaam, David; Weller, Robert; Akhtar, Shamsuddin; Blessing, Marcelle; Johnson, Chanel; Kampp, Michael; Kunze, Kimberly; Li, Jinlei; O'Connor, Mary; Treggiari, Miriam
Engaging patients-defined broadly as individuals with lived experience of a given condition, family members, caregivers, and the organisations that represent them-as partners in research is a priority for policymakers, funders, and the public. Nonetheless, formal efforts to engage patients are absent from most studies, and models to support meaningful patient engagement in clinical anaesthesia research have not been previously described. Here, we review our experience in developing and implementing a multifaceted patient engagement strategy within the Regional Versus General Anesthesia for Promoting Independence After Hip Fracture (REGAIN) surgery trial, an ongoing randomised trial comparing spinal vs general anaesthesia for hip fracture surgery in 1600 older adults across 45 hospitals in the USA and Canada. This strategy engaged patients and their representatives at both the level of overall trial oversight and at the level of individual recruiting sites. Activities spanned a continuum ranging from events designed to elicit patients' input on key decisions to longitudinal collaborations that empowered patients to actively participate in decision-making related to trial design and management. Engagement activities were highly acceptable to participants and led to concrete changes in the design and conduct of the REGAIN trial. The REGAIN experience offers a model for future efforts to engage patients as partners in clinical anaesthesia research, and highlights potential opportunities for investigators to increase the relevance of anaesthesia studies by incorporating patient voices and perspectives into the research process.
PMID: 33279102
ISSN: 1471-6771
CID: 5022622
Platelet aggregation and coagulation factors in orthopedic surgery
Oberweis, Brandon S; Cuff, Germaine; Rosenberg, Andrew; Pardo, Luis; Nardi, Michael A; Guo, Yu; Dweck, Ezra; Marshall, Mitchell; Steiger, David; Stuchin, Steven; Berger, Jeffrey S
Hemostasis is a major concern during the perioperative period. Changes in platelet aggregation and coagulation factors may contribute to the delicate balance between thrombosis and bleeding. We sought to better understand perioperative hemostasis by investigating the changes in platelet aggregation and coagulation factors during the perioperative period. We performed a prospective cohort analysis of 70 subjects undergoing non-emergent orthopedic surgery of the knee (n = 28), hip (n = 35), or spine (n = 7) between August 2011 and November 2011. Plasma was collected preoperatively (T1), 1-h intraoperatively (T2), 1-h (T3), 24-h (T4) and 48-h (T5) postoperatively. Platelet function testing was performed using whole blood impedance aggregometry. Coagulation assays were performed for factor VII, factor VIII, von Willebrand Factor (vWF), and fibrinogen. Of the 70 patients, mean age was 64.1 +/- 9.8 years, 61 % were female, and 74 % were Caucasian. Platelet activity decreased until 1 h postoperatively and then significantly increased above baseline at 24- and 48-h postoperatively. Compared to baseline, coagulation factors decreased intraoperatively. Factor VII activity continued to decrease, while FVIII, vWF, and fibrinogen all increased above baseline postoperatively. The results of our study indicate significant changes in platelet activity and coagulation factors during the perioperative period. Both platelet activity and markers of coagulation decrease during the intraoperative period and then some increase postoperatively. These changes may contribute to the hypercoagulabity and/or bleeding risk that occurs in the perioperative period. Future prospective studies aimed at correlating hemostatic changes with perioperative outcomes are warranted.
PMID: 24874897
ISSN: 0929-5305
CID: 1018852
Changes in hemostasis during the perioperative period of orthopedic surgery [Meeting Abstract]
Oberweis, B.; Nardi, M. A.; Cuff, G.; Rosenberg, A.; Pardo, L.; Guo, Y.; Marshall, M.; Steiger, D.; Stuchin, S.; Berger, J. S.
ISI:000331833602402
ISSN: 1538-7933
CID: 875242
Three partial-task simulators for teaching ultrasound-guided regional anesthesia
Rosenberg, Andrew D; Popovic, Jovan; Albert, David B; Altman, Robert A; Marshall, Mitchell H; Sommer, Richard M; Cuff, Germaine
ABSTRACT: Simulation-based training is becoming an accepted tool for educating physicians before direct patient care. As ultrasound-guided regional anesthesia (UGRA) becomes a popular method for performing regional blocks, there is a need for learning the technical skills associated with the technique. Although simulator models do exist for learning UGRA, they either contain food and are therefore perishable or are not anatomically based. We developed 3 sonoanatomically based partial-task simulators for learning UGRA: an upper body torso for learning UGRA interscalene and infraclavicular nerve blocks, a femoral manikin for learning UGRA femoral nerve blocks, and a leg model for learning UGRA sciatic nerve blocks in the subgluteal and popliteal areas
PMID: 22189577
ISSN: 1532-8651
CID: 147708
The educational value of peripheral nerve block workshops [Meeting Abstract]
Rosenberg AD; Connell F; Spessot G; Marshall M; Albert D
ORIGINAL:0004988
ISSN: 0003-3022
CID: 47339
Are peripheral nerve block workshops a valuable educational tool? [Meeting Abstract]
Rosenberg, AD; Bernstein, RL; Albert, DB; Marshall, MH; Altman, RA; Thomas, SJ
ISI:A1997WF78000206
ISSN: 0003-2999
CID: 53301
