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ASA classification indicates variance in length of stay, inpatient cost after fracture surgery
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The American Society of Anesthesiologists classification indicated length of stay and total inpatient cost variances for patients who are hospitalized after an isolated fracture procedure, based on study results published in the Journal of Orthopedic Trauma.
Researchers retrospectively reviewed charts of patients who underwent 10 selected isolated orthopedic surgical fracture procedures between January 2000 and December 2010, identified 13,776 distinct operations by CPT code and included 1,398 of them in their analysis. The main outcome measures the researchers used in the study were length of stay (LOS) and cost secondary to LOS.
According to the results, postoperative LOS for the eight most common lower extremity and the two most common upper extremity isolated orthopedic fracture procedures were strongly predicted by a patient’s American Society of Anesthesiologists (ASA) physical status. Researchers found that, with the exception of procedures with CPT code 27536, ASA served as a significant predictor of inpatient cost for all isolated orthopedic procedures the investigators analyzed in the study.
“Given that ASA classification is universally collected, this method can easily be used in almost any hospital system and for any operative service. This model may be used to predict more accurately a patient’s postoperative course and thus the expected cost to the hospitals for given procedure,” the researchers wrote in the study. “Orthopedic surgeons should understand the predictive factors behind length of stay and the associated increases in hospital costs such that they can be prepared to negotiate surgical and postoperative treatment. Ultimately, the methodology used in this article for the 10 most common orthopaedic trauma fractures can be applied across multiple institutions and fracture types to create a more generalized model for the use of the ASA score.”
Disclosure: William T. Obremskey, MD, MPH, was previously a consultant for Biometrics and has a grant from the Department of Defense.
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