Supplementary materials
Supplementary Figure 1. Proportion of encounters and sites by site characteristic
Urban Academic
400+ Beds 200-399 Beds
0-199 Beds South
Midwest West
Northeast 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100% 90%
50% 54%
31%
15%
48%
23% 17%
12%
73% 30% 21% 30% 49% 41% 26% 18% 14%
% E n co u n te rs o r Si te s
Supplementary Table 1.
Rank within procedure classificati
on
Procedure Classification
Top 10 Primary ICD Codes / Description within each procedure classification
Encounters(n) including these
codes*
% within each procedure
class
Cumulative percent
Cardiovascular N = 520,482
1 02100Z9 Bypass Coronary Artery, One Artery From
Left Internal Mammary, Open Approach 41,358 7.95% 7.95%
2 02RF08Z Replacement Of Aortic Valve With Zooplastic
Tissue, Open Approach 21,851 4.20% 12.14%
3 38.12 Head/Neck Endarterectomy 20,608 3.96% 16.10%
4 021109W Bypass Coronary Artery, Two Arteries From Aorta With Autologous Venous Tissue, Open Approach
13,428 2.58% 18.68%
5 36.12 Aortocoronary Bypass, Two Arteries 13,137 2.52% 21.21%
6 03CK0ZZ Extirpation Of Matter From Right Internal
Carotid Artery, Open Approach 12,446 2.39% 23.60%
7 03CL0ZZ Extirpation Of Matter From Left Internal
Carotid Artery, Open Approach 12,197 2.34% 25.94%
8 36.13 Aortocoronary Bypass Three Arteries 11,062 2.13% 28.07%
9 04V03DZ Restriction Of Abdominal Aorta With
Intraluminal Device, Percutaneous Approach 9,961 1.91% 29.98%
10 02HV33Z Insertion Of Infusion Device Into Superior
Vena Cava, Percutaneous Approach 9,746 1.87% 31.85%
11 35.21 Open Replac Aortc Val W/Tis Graft 9,402 1.81% 33.66%
12 021209W Bypass Coronary Artery, Three Arteries From Aorta With Autologous Venous Tissue, Open Approach
9,050 1.74% 35.40%
13 39.29 Vascular Shunt Or Bypass Nec 8,651 1.66% 37.06%
14 02RF38Z Replacement Of Aortic Valve With Zooplastic
Tissue, Percutaneous Approach 8,276 1.59% 38.65%
15 4A023N7 Measurement Of Cardiac Sampling And
Pressure, Left Heart, Percutaneous Approach 7,909 1.52% 40.17%
Digestiv
e N= 1213034
1 0FT44ZZ Resection Of Gallbladder, Percutaneous
Endoscopic Approach 156,180 12.88% 12.88%
2 51.23 Laparoscopic Cholecystectomy 83,629 6.89% 19.77%
3 0DB64Z3 Excision Of Stomach, Percutaneous
Endoscopic Approach, Vertical 78,645 6.48% 26.25%
4 0DTJ4ZZ Resection Of Appendix, Percutaneous
Endoscopic Approach 60,573 4.99% 31.25%
5 0D164ZA Bypass Stomach To Jejunum, Percutaneous
Endoscopic Approach 34,407 2.84% 34.08%
6 47.01 Laparoscopic Appendectomy 33,471 2.76% 36.84%
7 43.82 Laparoscopic Sleeve Gastrectomy 27,644 2.28% 39.12%
8 0WUF0JZ Supplement Abdominal Wall With Synthetic
Substitute, Open Approach 23,408 1.93% 41.05%
9 0DTN0ZZ Resection Of Sigmoid Colon, Open Approach 21,524 1.77% 42.82%
10 0DTF0ZZ Resection Of Right Large Intestine, Open
Approach 19,941 1.64% 44.47%
11 0DTN4ZZ Resection Of Sigmoid Colon, Percutaneous
Endoscopic Approach 16,332 1.35% 45.82%
12 0DTF4ZZ Resection Of Sigmoid Colon, Percutaneous
Endoscopic Approach 16,104 1.33% 47.14%
13 44.38 Laparoscopic Gastroenterostomy 15,414 1.27% 48.41%
14 0DBN0ZZ Excision Of Sigmoid Colon, Open Approach 15,151 1.25% 49.66%
15 0DB80ZZ Excision Of Small Intestine, Open Approach 13,817 1.14% 50.80%
Endocrin
e N= 21251
1 0GTK0ZZ Resection Of Thyroid Gland, Open Approach 2,596 12.22% 12.22%
2 6.4 Complete Thyroidectomy 2,514 11.83% 24.05%
3 0GB04ZZ Excision Of Pituitary Gland, Percutaneous
Endoscopic Approach 2,125 10.00% 34.05%
4 7.62 Part Pituitary Excise, Transsphen 1,585 7.46% 41.50%
5 0GB00ZZ Excision Of Pituitary Gland, Open Approach 1,317 6.20% 47.70%
6 0GTG0ZZ Resection Of Left Thyroid Gland Lobe, Open
Approach 1,042 4.90% 52.60%
7 0GT24ZZ Resection Of Left Adrenal Gland,
Percutaneous Endoscopic Approach 973 4.58% 57.18%
8 7.22 Unilateral Adrenalectomy 946 4.45% 61.63%
9 6.2 Unilateral Thyroid Lobectomy 769 3.62% 65.25%
10 0GT34ZZ Resection Of Right Adrenal Gland,
Percutaneous Endoscopic Approach 709 3.34% 68.59%
11 0GTH0ZZ Resection Of Right Thyroid Gland Lobe, Open
Approach 593 2.79% 71.38%
12 6.89 Parathyroidectomy Nec 536 2.52% 73.90%
13 0GT04ZZ Resection Of Pituitary Gland, Percutaneous
Endoscopic Approach 457 2.15% 76.05%
14 7.65 Total Pituitary Exc, Transsphenoid 366 1.72% 77.78%
15 6.39 Partial Thyroidectomy Nec 227 1.07% 78.84%
ENT N= 27517
1 27 Drainage Of Face And Mouth Floor 1,410 5.12% 5.12%
2 0CTPXZZ Resection Of Tonsils, External Approach 1,122 4.08% 9.20%
3 0CTS0ZZ Resection Of Larynx, Open Approach 1,036 3.76% 12.97%
4 25.2 Partial Glossectomy 656 2.38% 15.35%
5 0CDXXZ1 Extraction Of Lower Tooth, Multiple, External
Approach 654 2.38% 17.73%
6 28.2 Tonsillectomy 616 2.24% 19.97%
7 0CJS8ZZ Inspection Of Larynx, Via Natural Or Artificial
Opening Endoscopic 614 2.23% 22.20%
8 0CB7XZZ Excision Of Tongue, External Approach 584 2.12% 24.32%
9 0W950ZZ Drainage Of Lower Jaw, Open Approach 529 1.92% 26.24%
10 0W9500Z Drainage Of Lower Jaw With Drainage
Device, Open Approach 505 1.84% 28.08%
11 28 Peritonsillar Incision/Drainage 474 1.72% 29.80%
12 0CB70ZZ Excision Tongue, Open Approach 451 1.64% 31.44%
13 23.19 Surgical Tooth Extraction Nec 419 1.52% 32.96%
14 0CDXXZ0 Extraction Of Lower Tooth, Single, External
Approach 407 1.48% 34.44%
15 23.09 Tooth Extraction Nos 392 1.42% 35.87%
Eye And Ocular Adnexa N= 2838
1 08Q7XZZ Repair Left Sclera, External Approach 128 4.51% 4.51%
2 8.81 Linear Repair, Eyelid Laceration 121 4.26% 8.77%
3 16.82 Repair Eyeball Rupture 113 3.98% 12.76%
4 08Q6XZZ Repair Right Sclera, External Approach 106 3.74% 16.49%
5 08Q9XZZ Repair Left Cornea, External Approach 95 3.35% 19.84%
6 08Q8XZZ Repair Right Cornea, External Approach 90 3.17% 23.01%
7 16.09 Orbitotomy Nec 75 2.64% 25.65%
8 15.9 Extraocular Muscle/Tendon Ops Nec 74 2.61% 28.26%
9 08T0XZZ Resection Of Right Eye, External Approach 68 2.40% 30.66%
10 11.51 Suture Of Corneal Laceration 66 2.33% 32.98%
11 08Q0XZZ Repair Right Eye, External Approach 57 2.01% 34.99%
12 08QNXZZ Repair Right Eye, External Approach 56 1.97% 36.96%
13 08R10JZ Replacement Of Left Eye With Synthetic
Substitute, Open Approach 54 1.90% 38.87%
14 08R00JZ Replacement Of Right Eye With Synthetic
Substitute, Open Approach 53 1.87% 40.73%
15 08QPXZZ Repair Left Upper Eyelid, External Approach 51 1.80% 42.53%
Female Genital N= 230611
1 0UT90ZZ Resection Of Uterus, Open Approach 61,830 26.81% 26.81%
2 68.49 Total Abdominal Hysterectomy Nos 32,999 14.31% 41.12%
3 0UT94ZZ Resection Of Uterus, Percutaneous
Endoscopic Approach 10,515 4.56% 45.68%
4 0UT9FZZ Resection Of Uterus, Via Natural Or Artificial Opening With Percutaneous Endoscopic Assistance
8,740 3.79% 49.47%
5 0UB90ZZ Excision Of Uterus, Open Approach 8,210 3.56% 53.03%
6 68.41 Lap Total Abdominal Hysterectomy 7,679 3.33% 56.36%
7 0UT20ZZ Resection Of Bilateral Ovaries, Open
Approach 5,702 2.47% 58.83%
8 65.61 Remove Ovaries/Tubes Same Op Nec 5,608 2.43% 61.26%
9 0UT97ZZ Resection Of Uterus, Via Natural Or Artificial
Opening 5,485 2.38% 63.64%
10 0UT70ZZ Resection Of Bilateral Fallopian Tubes, Open
Approach 5,127 2.22% 65.87%
11 68.51 Lap Assisted Vaginal Hysterectomy 4,881 2.12% 67.98%
12 68.59 Vaginal Hysterectomy Nos 4,871 2.11% 70.10%
13 68.29 Uterine Lesion Destruction Nec 4,623 2.00% 72.10%
14 68.39 Subtotal Abdominal Hysterectomy Nos 4,619 2.00% 74.10%
15 65.49 Unilat Salpingo-Oophorectomy Nec 3,274 1.42% 75.52%
Integumentary Hemic And Lymphatic N= 146206
1 86.22 Excisional Wound/Burn Debridement 5,635 3.85% 3.85%
2 86.04 Incise Skin/Subcut W/Drainage Nec 5,480 3.75% 7.60%
3 0HTV0ZZ Resection Of Bilateral Breast, Open
Approach 5,333 3.65% 11.25%
4 07TP0ZZ Resection Of Spleen, Open Approach 3,375 2.31% 13.56%
5 0JB80ZZ Excision Of Abdomen Subcutaneous Tissue
And Fascia, Open Approach 3,370 2.30% 15.86%
6 85.43 Unilateral Extend Simple Mastectomy 2,626 1.80% 17.66%
7 0JB70ZZ Excision Of Back Subcutaneous Tissue And
Fascia, Open Approach 2,538 1.74% 19.40%
8 85.42 Bilateral Simple Mastectomy 2,327 1.59% 20.99%
9 41.5 Total Splenectomy 2,308 1.58% 22.57%
10 86.28 Nonexcisional Wound Debridement 2,107 1.44% 24.01%
11 07B74ZX Excision Of Thorax Lymphatic, Percutaneous
Endoscopic Approach, Diagnostic 2,100 1.44% 25.44%
12 0HTU0ZZ Resection Of Left Breast, Open Approach 2,038 1.39% 26.84%
13 0HTT0ZZ Resection Of Right Breast, Open Approach 1,977 1.35% 28.19%
14 0JB90ZZ Excision Of Buttock Subcutaneous Tissue
And Fascia, Open Approach 1,919 1.31% 29.50%
15 85.41 Unilateral Simple Mastectomy 1,711 1.17% 30.67%
Respiratory N= 158834
1 0B110F4 Bypass Trachea To Cutaneous With
Tracheostomy Device, Open Approach 10,087 6.35% 6.35%
2 32.2 Thoracospc Excis Lesion/Tiss Lung 6,397 4.03% 10.38%
3 31.1 Temporary Tracheostomy 5,248 3.30% 13.68%
4 0B113F4 0b113f4 4,636 2.92% 16.60%
5 32.49 Other Lobectomy Of Lung 4,341 2.73% 19.33%
6 32.41 Thorascpc Lobectomy Lung 3,828 2.41% 21.74%
7 0BTC4ZZ Resection Of Right Upper Lung Lobe,
Percutaneous Endoscopic Approach 3,414 2.15% 23.89%
8 0BBC4ZZ Excision Of Right Upper Lung Lobe,
Percutaneous Endoscopic Approach 3,132 1.97% 25.87%
9 0BQT4ZZ Repair Diaphragm, Percutaneous Endoscopic
Approach 3,116 1.96% 27.83%
10 34.52 Thoracoscp Decortication Of Lung 2,898 1.82% 29.65%
11 0BBG4ZZ Excision Of Left Upper Lung Lobe,
Percutaneous Endoscopic Approach 2,729 1.72% 31.37%
12 0BTC0ZZ Resection Of Right Upper Lung Lobe, Open
Approach 2,532 1.59% 32.96%
13 0BTG4ZZ Resection Of Left Upper Lung Lobe,
Percutaneous Endoscopic Approach 2,459 1.55% 34.51%
14 0BJ08ZZ Inspection Of Tracheobronchial Tree, Via
Natural Or Artificial Opening Endoscopic 2,424 1.53% 36.04%
15 0BBF4ZZ Excision Of Right Lower Lung Lobe,
Percutaneous Endoscopic Approach 2,268 1.43% 37.47%
Musculoskeletal And Nervous N= 1530397
1 81.54 Total Knee Replacement 69,073 4.51% 4.51%
2 81.51 Total Hip Replacement 62,882 4.11% 8.62%
3 0SRC0J9 Replacement Of Right Knee Joint With Synthetic Substitute, Cemented, Open Approach
52,785 3.45% 12.07%
4 0SRD0J9 Replacement Of Left Knee Joint With Synthetic Substitute, Cemented, Open Approach
52,607 3.44% 15.51%
5 81.02 Cervical Fusion, Anterior Technique 36,835 2.41% 17.92%
6 0SG00AJ Fusion Of Lumbar Vertebral Joint With Interbody Fusion Device, Posterior Approach, Anterior Column, Open Approach
34,337 2.24% 20.16%
7 81.07 Lumbar/Sacral Fusion Post Col/Tech 31,714 2.07% 22.23%
8 0RG20A0 Fusion Of 2 Or More Cervical Vertebral Joints With Interbody Fusion Device, Anterior Approach, Anterior Column, Open Approach
25,002 1.63% 23.87%
9 0RRJ00Z Replacement Of Right Shoulder Joint With Reverse Ball And Socket Synthetic Substitute, Open Approach
22,764 1.49% 25.35%
10 81.08 Lumbar/Sacral Anterior Col Post Tec 21,001 1.37% 26.73%
11 0SR904A Replacement Of Right Hip Joint With Ceramic On Polyethylene Synthetic Substitute, Uncemented, Open Approach
20,077 1.31% 28.04%
12 01NB0ZZ Release Lumbar Nerve, Open Approach 18,251 1.19% 29.23%
13 3.09 Spinal Canal Exploration Nec 17,797 1.16% 30.39%
14 79.35 Op Fx Reduct W/Int Fix, Femur 17,442 1.14% 31.53%
15 0SRB04A Replacement Of Left Hip Joint With Ceramic On Polyethylene Synthetic Substitute, Uncemented, Open Approach
17,250 1.13% 32.66%
Urinary And Male Genital N= 172583
1 0VT04ZZ Resection Of Prostate, Percutaneous
Endoscopic Approach 30,131 17.46% 17.46%
2 60.5 Radical Prostatectomy 15,188 8.80% 26.26%
3 55.51 Nephroureterectomy 8,222 4.76% 31.02%
4 0TT14ZZ Resection Of Left Kidney, Percutaneous
Endoscopic Approach 6,275 3.64% 34.66%
5 0VT00ZZ Resection Of Prostate, Open Approach 5,526 3.20% 37.86%
6 0TT04ZZ Resection Of Right Kidney, Percutaneous
Endoscopic Approach 4,617 2.68% 40.54%
7 0T778DZ Dilation Of Left Ureter With Intraluminal Device, Via Natural Or Artificial Opening Endoscopic
4,541 2.63% 43.17%
8 0TB04ZZ Excision Of Right Kidney, Percutaneous
Endoscopic Approach 4,375 2.54% 45.70%
9 55.4 Partial Nephrectomy 4,329 2.51% 48.21%
10 0T768DZ Dilation Of Right Ureter With Intraluminal Device, Via Natural Or Artificial Opening Endoscopic
4,299 2.49% 50.70%
11 0TB14ZZ Excision Of Left Kidney, Percutaneous
Endoscopic Approach 4,206 2.44% 53.14%
12 0TT10ZZ Resection Of Left Kidney, Open Approach 3,977 2.30% 55.44%
13 59.8 Ureteral Catheterization 3,866 2.24% 57.68%
14 56 Remove Transurethral Obstruction 3,690 2.14% 59.82%
15 0TT00ZZ Resection Of Right Kidney, Open Approach 3,672 2.13% 61.95%
Supplementary Table 2. Site characteristics
Overall 2016 adopters 2017 adopters 2018
adopters 2019
adopters Non- adopters Number of
sites
927 325 232 117 51 202
35.1% 25.0% 12.6% 5.5% 21.8%
Sites contributing to PHD database in year
2014 752 290 177 81 30 174
2015 765 300 195 83 32 155
2016 756 323 206 83 35 109
2017 746 314 231 93 39 69
2018 730 283 222 114 45 66
2019 682 255 216 109 50 52
Center
Academic 275 111 72 36 7 49
Non-
academic 652 214 160 81 44 153
Bed size
0–199 441 88 104 76 22 151
200–399 273 87 61 39 5 81
400+ 195 98 40 14 3 40
Area
Urban 662 215 159 93 14 181
Non-urban 247 58 46 36 16 91
Region
Northeast 130 17 28 32 4 49
Midwest 238 88 52 31 9 58
West 168 49 34 18 7 60
South 373 119 91 48 10 105
Overall 2016 adopters 2017 adopters 2018
adopters 2019
adopters Non- adopters Number of
encounters 4,263,658 2,577,026 952,272 316,260 97,842 320,258
60.4% 22.3% 7.4% 2.3% 7.5%
Center
Academic 2,125,208 1,335,865 478,651 163,011 32,917 114,764
Non- academic
2,138,450 1,241,161 473,621 153,249 64,925 205,494
Bed size
0–199 650,373 251,186 263,064 43,698 38,318 54,107
200–399 1,338,120 714,266 294,391 154,920 28,321 146,222
400+ 2,275,165 1,611,574 394,817 117,642 31,203 119,929
Area
Urban 3,837,835 2,332,314 848,205 283,167 87,781 286,368
Non-urban 425,823 244,712 104,067 33,093 10,061 33,890
Region
Northeast 526,340 159,750 163,896 112,640 35,719 54,335
Midwest 950,357 705,541 179,336 21,937 336 43,207
West 752,527 385,545 171,047 42,739 34,327 118,869
2,034,434 1,326,190 437,993 138,944 27,460 103,847
Supplementary Table 3. Multivariable regression results: factors associated with a) active reversal versus spontaneous recovery on full sample (Model 1a) , b)– sugammadex use versus neostigmine (Model 2a), Odds ratio estimates and 95% CI
Model 1a: active vs. spontaneous reversal
N=3,991,787
Model 2a: sugammadex vs. neostigmine N=1,324,647
Covariate OR (95% CI) P value OR (95% CI) P value
NMB Rocuronium or vecuronium vs. rocuronium with
succinylcholine or vecuronium with succinylcholine
1.298 (1.286, 1.311) <0.0001 0.925 (0.909, 0.941) <0.0001
Year
2014 vs. 2016 0.874 (0.868, 0.881) <0.0001 2015 vs. 2016 0.916 (0.910, 0.923) <0.0001
2017 vs. 2016 1.206 (1.197, 1.215) <0.0001 2.147 (2.118, 2.176) <0.0001 2018 vs. 2016 1.359 (1.348, 1.369) <0.0001 3.218 (3.176, 3.262) <0.0001 2019 vs. 2016 1.519 (1.505, 1.534) <0.0001 4.054 (3.995, 4.113) <0.0001 Age, categorical
18–30 vs. 31–40 1.036 (1.024, 1.049) <0.0001 0.927 (0.910, 0.944) <0.0001 41–50 vs. 31–40 0.978 (0.968, 0.987) <0.0001 1.057 (1.040, 1.073) <0.0001 51–60 vs. 31–40 0.975(0.966, 0.984) <0.0001 1.092 (1.076, 1.108) <0.0001 61–70 vs. 31–40 1.017(1.008, 1.027) 0.0003 1.087 (1.071, 1.103) <0.0001 71–80 vs. 31–40 1.095(1.085, 1.106) <0.0001 1.087 (1.070, 1.104) <0.0001 80+ vs. 31–40 1.243(1.229, 1.258) <0.0001 1.181 (1.159, 1.203) <0.0001 Gender
Female vs. Male 1.088(1.083, 1.093) <0.0001 0.979 (0.972, 0.987) <0.0001 Race
Black vs. White 1.069(1.060, 1.077) <0.0001 0.898 (0.887, 0.910) <0.0001 Other vs. White 0.909(0.902, 0.916) <0.0001 0.752 (0.743, 0.762) <0.0001 Hispanic ethnicity
Yes vs. No 1.006(0.997, 1.015) 0.2029 1.327 (1.309, 1.345) <0.0001 Admission type
Emergency/urgent vs. elective 0.715(0.712, 0.719) <0.0001 1.098 (1.090, 1.107) <0.0001 Trauma center vs. elective 0.697(0.686, 0.708) <0.0001 1.703 (1.660, 1.747) <0.0001
Supplementary Table 3, continued Model 1a: active vs. spontaneous reversal
N = 3,991,787
Model 2a: sugammadex vs. neostigmine N = 1,324,647
Covariate OR (95% CI) P value OR (95% CI) P value
Comorbidities
Cardiac Arrhythmias Yes vs. No 0.807 (0.802, 0.812) <0.0001 0.998 (0.987, 1.009) 0.7599 Chronic Pulmonary Disease Yes vs. No 0.994 (0.988, 1.000) 0.0348 1.089 (1.079, 1.100) <0.0001 Congestive Heart Failure Yes vs. No 0.814 (0.806, 0.822) <0.0001 1.101 (1.082, 1.120) <0.0001 Obesity,overweight Yes vs. No 1.030 (1.024, 1.036) <0.0001 1.050 (1.040, 1.059) <0.0001 Solid Tumor Without Metastasis Yes vs. No 1.087 (1.078, 1.096) <0.0001 1.059 (1.046, 1.071) <0.0001 Sleep Apnea Yes vs. No 1.012 (1.004, 1.021) 0.0051 0.980 (0.967, 0.993) 0.0021 Diabetes (complicated) Yes vs. No 0.841 (0.833, 0.849) <0.0001 1.027 (1.012, 1.041) 0.0003 Peripheral Vascular Disorders Yes vs. No 1.421 (1.408, 1.434) <0.0001 1.057 (1.041, 1.074) <0.0001 Valvular Disease Yes vs. No 0.714 (0.707, 0.721) <0.0001 0.940 (0.923, 0.957) <0.0001 Hospital bed size
0-199 vs. 400+ 0.932 (0.926, 0.939) <0.0001 0.823 (0.814, 0.833) <0.0001 200-399 vs. 400+ 0.967 (0.962, 0.973) <0.0001 0.846 (0.839, 0.854) <0.0001 Geographic region
MIDWEST vs. WEST 1.471 (1.460, 1.481) <0.0001 0.760 (0.751, 0.770) <0.0001 NORTHEAST vs. WEST 1.431 (1.419, 1.444) <0.0001 0.440 (0.433, 0.447) <0.0001 SOUTH vs. WEST 1.340 (1.332, 1.348) <0.0001 0.529 (0.523, 0.535) <0.0001 Teaching status
Teaching vs. non-teaching 1.069 (1.063, 1.075) <0.0001 0.852 (0.845, 0.860) <0.0001 Procedure Classification Cardiovascular vs. Musculoskeletal and nervous 0.430 (0.427, 0.434) <0.0001 1.040 (1.024, 1.055) <0.0001 Digestive vs. Musculoskeletal and nervous 2.398 (2.383, 2.412) <0.0001 1.022 (1.013, 1.032) <0.0001 Endocrine vs. Musculoskeletal and nervous 0.783 (0.761, 0.806) <0.0001 1.175 (1.115, 1.239) <0.0001 ENT vs. Musculoskeletal and nervous 0.639 (0.624, 0.655) <0.0001 1.535 (1.466, 1.608) <0.0001 Eye vs. Musculoskeletal and nervous 1.103 (1.019, 1.193) 0.0156 1.534 (1.347, 1.746) <0.0001 Female genital vs. Musculoskeletal and nervous 2.043 (2.019, 2.067) <0.0001 0.987 (0.969, 1.004) 0.1355 Integumentary hemic and lymphatic vs. Musculoskeletal
and nervous
0.852 (0.842, 0.862) <0.0001 1.163 (1.140, 1.187) <0.0001
Respiratory vs. Musculoskeletal and nervous 1.086 (1.074, 1.099) <0.0001 1.409 (1.382, 1.436) <0.0001 Urinary and male genital vs. Musculoskeletal and nervous 1.568 (1.549, 1.587) <0.0001 1.020 (1.001, 1.039) 0.0403
Supplementary Table 4. Odds Ratio estimates and 95% CIs: Model 2c – sugammadex use versus neostigmine use accounting for sugammadex adoption time for sites with continuous enrollment from 2016 to 2019 (N = 1,145,901)
Covariate OR (95% CI) P value
NMB Rocuronium or vecuronium vs. Rocuronium with succinylcholine or
Vecuronium with succinylcholine 1.056 (1.035, 1.078) <0.0001 Adoption year 2017 vs. 2016 0.417 (0.412, 0.421) <0.0001 2018+ vs. 2016 0.115 (0.111, 0.119) <0.0001 Age, categorical 18–30 vs. 31–40 0.927 (0.909, 0.946) <0.0001 41–50 vs. 31–40 1.041 (1.023, 1.058) <0.0001 51–60 vs. 31–40 1.063 (1.047, 1.081) <0.0001 61–70 vs. 31-40 1.075 (1.058, 1.092) <0.0001 71–80 vs. 31–40 1.107 (1.088, 1.126) <0.0001 80+ vs. 31–40 1.185 (1.161, 1.209) <0.0001 Gender Female vs. Male 0.980 (0.972, 0.988) <0.0001 Race Black vs. White 0.982 (0.968, 0.995) 0.0064 Other vs. White 0.989 (0.975, 1.003) 0.1164 Hispanic ethnicity Yes vs. No 1.113 (1.096, 1.131) <0.0001 Admission type Emergency/Urgent vs. Elective 1.176 (1.166, 1.186) <0.0001 Trauma Center vs. Elective 1.904 (1.853, 1.957) <0.0001 Comorbidities Cardiac Arrhythmias Yes vs. No 1.009 (0.997, 1.021) 0.1628 Chronic Pulmonary Disease Yes vs. No 1.064 (1.054, 1.075) <0.0001 Congestive Heart Failure Yes vs. No 1.218 (1.196, 1.241) <0.0001 Obesity,overweight Yes vs. No 1.031 (1.021, 1.041) <0.0001 Solid Tumor Without Metastasis Yes vs. No 1.052 (1.038, 1.066) <0.0001 Sleep Apnea Yes vs. No 0.995 (0.981, 1.009) 0.4484 Diabetes (complicated) Yes vs. No 1.095 (1.078, 1.112) <0.0001 Peripheral Vascular Disorders Yes vs. No 1.037 (1.020, 1.054) <0.0001 Valvular Disease Yes vs. No 0.965 (0.946, 0.985) 0.0005 Hospital bed size 0–199 vs. 400+ 1.027 (1.013, 1.040) <0.0001 200–399 vs. 400+ 0.974 (0.964, 0.983) <0.0001 Geographic region MIDWEST vs. WEST 0.533 (0.525, 0.540) <0.0001 NORTHEAST vs. WEST 0.712 (0.700, 0.725) <0.0001 SOUTH vs. WEST 0.453 (0.447, 0.459) <0.0001 Teaching status Teaching vs. non-teaching 0.914 (0.906, 0.923) <0.0001 ICD classification Cardiovascular vs. Musculoskeletal and nervous 1.089 (1.072, 1.107) <0.0001 Digestive vs. Musculoskeletal and nervous 1.058 (1.047, 1.068) <0.0001 Endocrine vs. Musculoskeletal and nervous 1.270 (1.198, 1.348) <0.0001 Eye vs. Musculoskeletal and nervous 1.808 (1.563, 2.090) <0.0001 Female genital vs. Musculoskeletal and nervous 0.990 (0.971, 1.009) 0.2855 Integumentary hemic and lymphatic vs. Musculoskeletal and
nervous
1.222 (1.196, 1.249) <0.0001 Respiratory vs. Musculoskeletal and nervous 1.468 (1.438, 1.498) <0.0001 Urinary and male genital vs. Musculoskeletal and nervous 1.017 (0.997, 1.038) 0.0934 The adoption year 2016 includes institutions with first use of sugammadex from December 2015 to December
2016.
Supplementary Table 5. Multivariable regression results: factors associated with active reversal versus spontaneous recovery stratified by region (Model 1B) – Odds ratio estimates and 95% confidence intervals
Covariate Midwest (OR, 95% CI)
N=898,700
P value Northeast (OR, 95%
CI)
N = 497,160
P value South (OR, 95% CI)
N =1,893,734
P value West (OR, 95% CI)
N =702,193
P value
NMB Rocuronium or vecuronium vs.
rocuronium with succinylcholine or vecuronium with succinylcholine
0.925 (0.904, 0.947) <0.0001 2.261 (2.136, 2.393) <0.0001 1.429 (1.412, 1.446) <0.0001 1.242 (1.208, 1.276) <0.0001
Year 2014 vs. 2016 0.818 (0.805, 0.831) <0.0001 0.852 (0.833, 0.872) <0.0001 0.906 (0.897, 0.916) <0.0001 0.872 (0.859, 0.886) <0.0001 2015 vs. 2016 0.876 (0.862, 0.890) <0.0001 0.912 (0.891, 0.933) <0.0001 0.938 (0.928, 0.948) <0.0001 0.919 (0.905, 0.934) <0.0001 2017 vs. 2016 1.204 (1.185, 1.223) <0.0001 1.148 (1.121, 1.175) <0.0001 1.188 (1.176, 1.201) <0.0001 1.314 (1.292, 1.337) <0.0001 2018 vs. 2016 1.406 (1.384, 1.429) <0.0001 1.160 (1.135, 1.186) <0.0001 1.364 (1.349, 1.379) <0.0001 1.549 (1.520, 1.578) <0.0001 2019 vs. 2016 1.624 (1.590, 1.658) <0.0001 1.118 (1.089, 1.147) <0.0001 1.582 (1.560, 1.604) <0.0001 1.790 (1.746, 1.836) <0.0001 Age, categorical 18–30 vs. 31–40 1.033 (1.006, 1.060) 0.0181 1.017 (0.983, 1.052) 0.3414 1.034 (1.017, 1.052) 0.0001 1.048 (1.021, 1.075) 0.0005 41–50 vs. 31–40 0.975 (0.954, 0.997) 0.0259 0.981 (0.953, 1.010) 0.1872 0.980 (0.966, 0.994) 0.0059 0.969 (0.948, 0.992) 0.0073 51–60 vs. 31–40 0.980 (0.960, 1.000) 0.0511 1.011 (0.983, 1.039) 0.4487 0.968 (0.955, 0.981) <0.0001 0.951 (0.931, 0.971) <0.0001 61–70 vs. 31–40 1.013 (0.993, 1.034) 0.2074 1.034 (1.006, 1.063) 0.0161 1.016 (1.003, 1.030) 0.0171 0.995 (0.974, 1.016) 0.6414 71–80 vs. 31–40 1.093 (1.069, 1.117) <0.0001 1.067 (1.036, 1.099) <0.0001 1.111 (1.095, 1.127) <0.0001 1.070 (1.046, 1.095) <0.0001 80+ vs. 31–40 1.269 (1.238, 1.302) <0.0001 1.158 (1.119, 1.198) <0.0001 1.260 (1.238, 1.282) <0.0001 1.245 (1.212, 1.279) <0.0001 Gender Female vs. Male 1.115 (1.103, 1.126) <0.0001 1.075 (1.060, 1.090) <0.0001 1.079 (1.071, 1.086) <0.0001 1.090(1.078, 1.101) <0.0001 Race Black vs. White 1.054 (1.036, 1.072) <0.0001 1.088 (1.061, 1.115) <0.0001 1.065 (1.054, 1.076) <0.0001 1.146 (1.112, 1.181) <0.0001 Other vs. White 0.884 (0.870, 0.899) <0.0001 0.792 (0.777, 0.807) <0.0001 0.968 (0.956, 0.979) <0.0001 0.915 (0.902, 0.928) <0.0001 Hispanic ethnicity Yes vs. No 1.044 (1.011, 1.078) 0.0083 1.256 (1.217, 1.297) <0.0001 0.920 (0.908, 0.931) <0.0001 1.129 (1.108, 1.151) <0.0001
Admission type Emergency/urgent vs. elective 0.663 (0.656, 0.670) <0.0001 0.613 (0.604, 0.622) <0.0001 0.744 (0.739, 0.749) <0.0001 0.789 (0.780, 0.798) <0.0001 Trauma Center vs. elective 0.583 (0.561, 0.605) <0.0001 0.691 (0.663, 0.720) <0.0001 0.795 (0.775, 0.816) <0.0001 0.657 (0.636, 0.679) <0.0001 Comorbidities Cardiac arrhythmias Yes vs. No 0.785 (0.775, 0.796) <0.0001 0.793 (0.779, 0.808) <0.0001 0.807 (0.800, 0.815) <0.0001 0.837 (0.824, 0.849) <0.0001 Chronic pulmonary disease Yes vs. No 0.995 (0.983, 1.007) 0.4100 1.008 (0.992, 1.026) 0.3264 0.988 (0.980, 0.997) 0.0067 1.010 (0.996, 1.024) 0.1760 Congestive heart failure Yes vs. No 0.824 (0.807, 0.841) <0.0001 0.819 (0.797, 0.843) <0.0001 0.809 (0.797, 0.821) <0.0001 0.812 (0.792, 0.832) <0.0001 Obesity, overweight Yes vs. No 1.022 (1.010, 1.035) 0.0005 1.000 (0.983, 1.017) 0.9676 1.033 (1.024, 1.042) <0.0001 1.063 (1.049, 1.078) <0.0001 Solid Tumor Yes vs. No 1.075 (1.055, 1.096) <0.0001 1.123 (1.096, 1.150) <0.0001 1.082 (1.069, 1.095) <0.0001 1.098 (1.077, 1.119) <0.0001 Sleep apnea Yes vs. No 1.012 (0.995, 1.030) 0.1761 1.013 (0.988, 1.038) 0.3166 1.006 (0.994, 1.019) 0.3157 0.993 (0.972, 1.014) 0.5135 Diabetes (complicated) Yes vs. No 0.845 (0.829, 0.862) <0.0001 0.857 (0.833, 0.882) <0.0001 0.827 (0.816, 0.838) <0.0001 0.877 (0.857, 0.899) <0.0001 Peripheral vascular disorders Yes vs.
No
1.474 (1.446, 1.503) <0.0001 1.469 (1.431, 1.509) <0.0001 1.432 (1.413, 1.451) <0.0001 1.319 (1.291, 1.348) <0.0001
Supplementary Table 5, continued
Covariate Midwest (OR, 95% CI) P value Northeast (OR, 95%
CI)
P value South (OR, 95% CI) P value West (OR, 95% CI) P value
Hospital bed size 0–199 vs. 400+ 0.911 (0.897, 0.926) <0.0001 1.538 (1.505, 1.572) <0.0001 0.802 (0.793, 0.810) <0.0001 0.880 (0.867, 0.894) <0.0001 200-399 vs. 400+ 0.975 (0.963, 0.987) <0.0001 1.044 (1.028, 1.061) <0.0001 0.929 (0.921, 0.937) <0.0001 0.944 (0.933, 0.956) 0.2563 Teaching status Teaching vs. non-teaching 1.120 (1.107, 1.133) <0.0001 1.528 (1.501, 1.554) <0.0001 0.943 (0.936, 0.950) <0.0001 1.123 (1.109, 1.137) <0.0001 ICD classification Cardiovascular vs. musculoskeletal
and nervous
0.386 (0.380, 0.392) <0.0001 0.358 (0.350, 0.367) <0.0001 0.447 (0.442, 0.452) <0.0001 0.517 (0.507, 0.526) <0.0001 Digestive vs. musculoskeletal and
nervous
2.309 (2.278, 2.340) <0.0001 1.769 (1.737, 1.801) <0.0001 2.433 (2.411, 2.455) <0.0001 3.065 (3.023, 3.109) <0.0001 Endocrine vs. musculoskeletal and
nervous
0.784 (0.734, 0.838) <0.0001 0.570 (0.524, 0.620) <0.0001 0.861 (0.826, 0.898) <0.0001 0.828 (0.779, 0.879) <0.0001 ENT vs. musculoskeletal and nervous 0.582 (0.553, 0.614) <0.0001 0.614 (0.569, 0.661) <0.0001 0.613 (0.591, 0.635) <0.0001 0.853 (0.807, 0.901) <0.0001 Eye vs. Musculoskeletal and nervous 1.338 (1.092, 1.638) 0.0049 1.122 (0.883, 1.426) 0.3448 1.023 (0.918, 1.139) 0.6836 1.244 (1.038, 1.491) 0.0182 Female genital vs. musculoskeletal
and nervous
1.789 (1.742, 1.836) <0.0001 1.575 (1.521, 1.632) <0.0001 2.256 (2.216, 2.296) <0.0001 2.346 (2.289, 2.404) <0.0001 Integumentary hemic and lymphatic
vs. musculoskeletal and nervous
0.842 (0.821, 0.865) <0.0001 0.860 (0.830, 0.890) <0.0001 0.799 (0.786, 0.812) <0.0001 1.076 (1.047, 1.105) <0.0001 Respiratory vs. musculoskeletal and
nervous
1.050 (1.024, 1.077) 0.0001 0.861 (0.833, 0.889) <0.0001 1.094 (1.075, 1.113) <0.0001 1.355 (1.319, 1.392) <0.0001 Urinary and male genital vs.
musculoskeletal and nervous 1.387 (1.350, 1.425) <0.0001 1.319 (1.272, 1.366) <0.0001 1.575 (1.547, 1.602) <0.0001 2.059 (2.003, 2.116) <0.0001
Supplementary Table 6. Factors associated with sugammadex use versus neostigmine (Model 2B) stratified by region – Odds ratio estimates and 95% confidence intervals
Covariate Midwest
(OR, 95% CI)
N = 354,114
P value Northeast
(OR, 95% CI)
N =157,697
P value South (OR, 95% CI)
N =649,612 P value West (OR, 95% CI)
N=163,224 P value
NMB Rocuronium or vecuronium
vs. Rocuronium with succinylcholine or Vecuronium with
succinylcholine
0.719 (0.696, 0.744)
<0.0001 1.114 (1.010, 1.228)
0.0301 0.964 (0.942, 0.986) 0.0018 1.576 (1.474, 1.685)
<0.0001
Year 2017 vs. 2016 1.990 (1.940, 2.041) <0.0001 3.402 (3.196, 3.622) <0.0001 2.187 (2.143, 2.231) <0.0001 2.201 (2.129, 2.275) <0.0001 2018 vs. 2016 3.612 (3.523, 3.704) <0.0001 3.212 (3.021, 3.415) <0.0001 3.355 (3.291, 3.421) <0.0001 3.288 (3.179, 3.401) <0.0001 2019 vs. 2016 5.352 (5.205, 5.504) <0.0001 4.148 (3.896, 4.416) <0.0001 4.117 (4.032, 4.205) <0.0001 3.695 (3.558, 3.837) <0.0001 Age, categorical 18–30 vs. 31–40 0.939 (0.904, 0.976) 0.0014 0.924 (0.874, 0.977) 0.0055 0.908 (0.884, 0.932) <0.0001 0.955 (0.909, 1.003) 0.0669 41–50 vs. 31–40 1.081 (1.048, 1.116) <.0001 1.058 (1.010, 1.108) 0.0180 1.059 (1.035, 1.083) <0.0001 1.040 (0.997, 1.086) 0.0698 51–60 vs. 31–40 1.118 (1.086, 1.152) <.0001 1.092 (1.045, 1.141) <.0001 1.093 (1.070, 1.117) <0.0001 1.102 (1.058, 1.148) <0.0001 61–70 vs. 31–40 1.142 (1.109, 1.176) <0.0001 1.115 (1.067, 1.166) <.0001 1.061 (1.038, 1.083) <0.0001 1.150 (1.105, 1.197) <0.0001 71–80 vs. 31–40 1.153 (1.118, 1.190) <0.0001 1.176 (1.122, 1.233) <0.0001 1.058 (1.034, 1.082) <0.0001 1.098 (1.052, 1.147) <0.0001 80+ vs. 31-40 1.256 (1.211, 1.303) <0.0001 1.423 (1.345, 1.505) <0.0001 1.114 (1.085, 1.145) <0.0001 1.196 (1.136, 1.259) <0.0001 Gender Female vs. Male 0.984 (0.969, 0.999) 0.0327 0.969 (0.947, 0.992) 0.0091 0.982 (0.971, 0.993) 0.0016 0.991 (0.970, 1.013) 0.4195 Race Black vs. White 1.035 (1.010, 1.060) 0.0055 0.917 (0.879, 0.956) <0.0001 0.910 (0.895, 0.925) <0.0001 0.661 (0.624, 0.700) <0.0001 Other vs. White 0.610 (0.593, 0.628) <0.0001 0.637 (0.617, 0.657) <0.0001 0.848 (0.832, 0.865) <0.0001 0.908 (0.882, 0.934) <0.0001 Hispanic ethnicity Yes vs. No 1.086 (1.036, 1.138) 0.0006 0.835 (0.794, 0.879) <0.0001 1.378 (1.355, 1.403) <0.0001 1.437 (1.388, 1.488) <0.0001 Admission type Emergency/Urgent vs.
Elective
1.067 (1.050, 1.084) <0.0001 0.880 (0.859, 0.901) <0.0001 1.189 (1.176, 1.203) <0.0001 1.039 (1.016, 1.062) <0.0001 Trauma Center vs. Elective 1.328 (1.256, 1.404) <0.0001 0.608 (0.560, 0.660) <0.0001 2.047 (1.971, 2.127) <0.0001 2.191 (2.054, 2.337) <0.0001 Comorbidities
Yes vs. No Cardiac Arrhythmias 0.999 (0.978, 1.021) 0.9376 0.971 (0.939, 1.004) 0.0845 1.006 (0.990, 1.022) 0.4747 0.999 (0.968, 1.031) 0.9498 Chronic Pulmonary Disease 1.049 (1.030, 1.068) <0.0001 1.091 (1.062, 1.122) <0.0001 1.112 (1.096, 1.128) <0.0001 1.067 (1.039, 1.097) <0.0001 Congestive Heart Failure 1.095 (1.060, 1.131) <0.0001 1.244 (1.180, 1.312) <0.0001 1.094 (1.067, 1.122) <0.0001 1.000 (0.951, 1.052) 0.9981 Obesity,overweight 1.090 (1.072, 1.109) <0.0001 1.195 (1.162, 1.227) <0.0001 1.019 (1.006, 1.033) 0.0049 0.965 (0.939, 0.991) 0.0078
Solid Tumor 1.186 (1.157, 1.215) <0.0001 1.048 (1.012, 1.086) 0.0088 1.024 (1.006, 1.042) 0.0085 0.961 (0.930, 0.993) 0.0159 Sleep Apnea 1.046 (1.021, 1.071) 0.0002 0.956 (0.920, 0.993) 0.0200 0.897 (0.880, 0.916) <0.0001 1.246 (1.198, 1.295) <0.0001 Diabetes (complicated) 0.990 (0.963, 1.018) 0.4849 0.973 (0.929, 1.020) 0.2549 1.061 (1.040, 1.082) <0.0001 0.950 (0.911, 0.992) 0.0192 Peripheral Vascular
Disorders
1.045 (1.014, 1.076) 0.0043 0.944 (0.899, 0.990) 0.0182 1.134 (1.109, 1.159) <0.0001 0.873 (0.834, 0.915) <0.0001 Valvular Disease 0.955 (0.923, 0.989) 0.0104 0.784 (0.743, 0.827) <0.0001 0.972 (0.946, 0.999) 0.0432 0.908 (0.861, 0.957) 0.0004 Hospital bed size 0-199 vs. 400+ 1.724 (1.686, 1.763) <0.0001 0.419 (0.403, 0.434) <0.0001 0.523 (0.513, 0.534) <0.0001 0.646 (0.627, 0.666) <0.0001 200-399 vs. 400+ 1.123 (1.103, 1.144) <0.0001 0.854 (0.831, 0.877) <0.0001 0.848 (0.837, 0.860) <0.0001 0.617 (0.601, 0.633) <0.0001 Teaching status Teaching vs. non-teaching 0.530 (0.521, 0.539) <0.0001 0.658 (0.639, 0.677) <0.0001 1.120 (1.106, 1.133) <0.0001 0.988 (0.963, 1.012) 0.3220 ICD classification
vs. Musculoskeletal and nervous
Cardiovascular 1.274 (1.237, 1.311) <0.0001 1.005 (0.959, 1.054) 0.8228 0.951 (0.932, 0.971) <0.0001 0.905 (0.867, 0.945) <0.0001 Digestive 1.216 (1.195, 1.238) <0.0001 1.305 (1.268, 1.342) <0.0001 0.943 (0.930, 0.956) <0.0001 0.845 (0.824, 0.868) <0.0001
Endocrine 1.906 (1.709, 2.126) <0.0001 1.112 (0.946, 1.307) 0.1995 1.026 (0.952, 1.105) 0.5081 0.833 (0.718, 0.967) 0.0165
ENT 2.317 (2.103, 2.554) <0.0001 1.129 (0.987, 1.292) 0.0757 1.530 (1.431, 1.635) <0.0001 1.057 (0.932, 1.199) 0.3892
Eye 1.829 (1.354, 2.471) <0.0001 0.800 (0.536, 1.195) 0.2761 1.827 (1.527, 2.186) <0.0001 0.773 (0.535, 1.118) 0.1714
Female genital 0.999 (0.964, 1.036) 0.9673 0.889 (0.839, 0.941) <0.0001 1.053 (1.026, 1.080) <0.0001 0.880 (0.840, 0.922) <0.0001 Integumentary hemic and
lymphatic
1.339(1.283, 1.397) <0.0001 1.133(1.067, 1.204) <0.0001 1.078(1.048, 1.109) <0.0001 1.123(1.062, 1.188) <0.0001 Respiratory 2.027 (1.952, 2.105) <0.0001 1.507 (1.427, 1.592) <0.0001 1.262 (1.228, 1.298) <0.0001 0.883 (0.837, 0.932) <0.0001 Urinary and male genital 1.185 (1.141, 1.231) <0.0001 1.316 (1.245, 1.391) <0.0001 0.933 (0.909, 0.959) <0.0001 0.845 (0.803, 0.890) <0.0001
Supplementary Table 7. Neuromuscular blockade agent in inpatient setting by patient characteristics
Patient characteristics Total (N = 4263658) Rocuronium only (N =
3668362) Rocuronium and
Succinylcholine (N = 205045)
Vecuronium only (N =
362530) Vecuronium and
Succinylcholine (N = 27721)
P value
Age <0.0001 n 4,263,658 (100.0%) 3,668,362 (100.0%) 205,045 (100.0%) 362,530 (100.0%) 27,721 (100.0%) Mean (SD) 58.2 (16.56) 58.2 (16.61) 56.1 (16.96) 59.4 (15.71) 57.1 (16.24) Min, Max 18 , 89 18 , 89 18 , 89 18 , 89 18 , 89 Median (P25, P75) 60 (47 , 70) 60 (47 , 70) 58 (44 , 69) 61 (50 , 71) 59 (46 , 69) 95% CI (58.1 , 58.2) (58.1 , 58.2) (56.1 , 56.2) (59.3 , 59.4) (57.0 , 57.3) Age categorial <0.0001 18-30 313,904 (7.4%) 271,031 (7.4%) 19,179 (9.4%) 21,507 (5.9%) 2,187 (7.9%) 31-40 395,318 (9.3%) 342,471 (9.3%) 22,505 (11.0%) 27,705 (7.6%) 2,637 (9.5%) 41-50 575,850 (13.5%) 496,767 (13.5%) 29,886 (14.6%) 45,280 (12.5%) 3,917 (14.1%) 51-60 887,726 (20.8%) 760,106 (20.7%) 43,081 (21.0%) 78,405 (21.6%) 6,134 (22.1%) 61-70 1,044,013 (24.5%) 893,101 (24.3%) 47,154 (23.0%) 96,881 (26.7%) 6,877 (24.8%) 71-80 722,225 (16.9%) 621,263 (16.9%) 29,707 (14.5%) 66,954 (18.5%) 4,301 (15.5%) 80+ 324,622 (7.6%) 283,623 (7.7%) 13,533 (6.6%) 25,798 (7.1%) 1,668 (6.0%) Gender <0.0001 Female 2,357,026 (55.3%) 2,054,500 (56.0%) 112,844 (55.0%) 176,298 (48.6%) 13,384 (48.3%) Male 1,904,508 (44.7%) 1,612,446 (44.0%) 91,588 (44.7%) 186,144 (51.3%) 14,330 (51.7%) Unable to determine 2,124 (0.0%) 1,416 (0.0%) 613 (0.3%) 88 (0.0%) 7 (0.0%) Race <0.0001 Black 429,017 (10.1%) 355,599 (9.7%) 24,033 (11.7%) 45,538 (12.6%) 3,847 (13.9%) Other 419,125 (9.8%) 367,421 (10.0%) 21,074 (10.3%) 28,519 (7.9%) 2,111 (7.6%) Unable to determine 70,866 (1.7%) 63,687 (1.7%) 2,065 (1.0%) 4,773 (1.3%) 341 (1.2%) White 3,344,650 (78.4%) 2,881,655 (78.6%) 157,873 (77.0%) 283,700 (78.3%) 21,422 (77.3%) Ethnicity (Hispanic) <0.0001 No 3,179,275 (74.6%) 2,725,862 (74.3%) 152,196 (74.2%) 277,829 (76.6%) 23,388 (84.4%) Unable to determine 785,820 (18.4%) 692,773 (18.9%) 25,180 (12.3%) 65,154 (18.0%) 2,713 (9.8%) Yes 298,563 (7.0%) 249,727 (6.8%) 27,669 (13.5%) 19,547 (5.4%) 1,620 (5.8%) Comorbidities>=1 3,351,656 (78.6%) 2,861,594 (78.0%) 159,957 (78.0%) 306,991 (84.7%) 23,114 (83.4%) <0.0001 AIDS 15,213 (0.4%) 12,784 (0.3%) 716 (0.3%) 1,610 (0.4%) 103 (0.4%) <0.0001
Alcohol Abuse 177,083 (4.2%) 145,759 (4.0%) 8,606 (4.2%) 20,842 (5.7%) 1,876 (6.8%) <0.0001 Blood Loss Anemia 47,309 (1.1%) 40,347 (1.1%) 2,575 (1.3%) 4,021 (1.1%) 366 (1.3%) <0.0001 Cardiac Arrhythmias 721,439 (16.9%) 594,956 (16.2%) 29,486 (14.4%) 91,056 (25.1%) 5,941 (21.4%) <0.0001 Chronic Pulmonary Disease 811,014 (19.0%) 688,512 (18.8%) 36,417 (17.8%) 80,265 (22.1%) 5,820 (21.0%) <0.0001 Coagulopathy 121,667 (2.9%) 98,735 (2.7%) 5,354 (2.6%) 16,477 (4.5%) 1,101 (4.0%) <0.0001 Congestive Heart Failure 260,761 (6.1%) 210,527 (5.7%) 9,000 (4.4%) 38,903 (10.7%) 2,331 (8.4%) <0.0001 Deficiency Anemia 105,899 (2.5%) 90,943 (2.5%) 5,549 (2.7%) 8,694 (2.4%) 713 (2.6%) <0.0001 Depression 587,410 (13.8%) 505,732 (13.8%) 28,030 (13.7%) 49,439 (13.6%) 4,209 (15.2%) <0.0001 Diabetes (complicated) 247,869 (5.8%) 208,246 (5.7%) 11,497 (5.6%) 25,898 (7.1%) 2,228 (8.0%) <0.0001 Supplemental Table 7, continued
Patient characteristics Total (N = 4263658) Rocuronium only (N =
3668362)
Rocuronium and Succinylcholine (N =
205045)
Vecuronium only (N = 362530)
Vecuronium and Succinylcholine (N =
27721)
P value
Diabetes (uncomplicated) 642,395 (15.1%) 542,964 (14.8%) 32,863 (16.0%) 62,288 (17.2%) 4,280 (15.4%) <0.0001 Drug Abuse 170,018 (4.0%) 141,269 (3.9%) 8,082 (3.9%) 18,962 (5.2%) 1,705 (6.2%) <0.0001 Fluid/Electrolyte Disorders 847,306 (19.9%) 705,355 (19.2%) 40,346 (19.7%) 93,885 (25.9%) 7,720 (27.8%) <0.0001 Hypertension (complicated) 151,208 (3.5%) 126,268 (3.4%) 4,930 (2.4%) 18,833 (5.2%) 1,177 (4.2%) <0.0001 Hypothyroidism 512,236 (12.0%) 443,234 (12.1%) 24,885 (12.1%) 41,208 (11.4%) 2,909 (10.5%) <0.0001 Liver Disease 218,530 (5.1%) 183,846 (5.0%) 12,061 (5.9%) 21,056 (5.8%) 1,567 (5.7%) <0.0001 Lymphoma 24,578 (0.6%) 21,032 (0.6%) 1,231 (0.6%) 2,167 (0.6%) 148 (0.5%) 0.0933 Metastatic neoplasm 158,357 (3.7%) 137,090 (3.7%) 7,466 (3.6%) 12,916 (3.6%) 885 (3.2%) <0.0001
