Comorbidities linked to increased length of stay in orthopedic procedures

LAS VEGAS — Common comorbidities were associated with a longer hospital length of stay after orthopedic procedures, and preventative measures could cut costs associated with length of stay, according to research presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

James J. Gholson, MD, and colleagues used the National Surgical Quality Improvement Program database to identify 92,266 patients who had 14 common orthopedic procedures. The investigators found patient comorbidities and characteristics, such as congestive heart failure and high BMI, cost patients more per day of hospitalization. Costs of hospitalization averaged $2,000 per day, and patients who had three comorbidities were likely to pay an additional $3,000 in costs after an orthopedic procedure. Patients with four comorbidities were likely to incur $4,000 in additional hospital costs through longer duration of stay than patients who had no comorbidities.

Modifiable factors, such as employing a weight gain strategy in underweight patients could reduce duration of stay by 1.46 days at a savings of about $2,020, Gholson noted.

He added that proactive steps, such as preoperative smoking cessation, exercise and weight loss, could reduce hospital stay duration and the additional costs of stays.

In addition, Gholson noted non-modifiable factors, such as age, can impact outcomes, and patients can be counseled regarding postoperative expectations in the presence of non-modifiable demographic factors that can increase the duration and cost of hospital stays. -by Shirley Pulawski

Reference: Gholson JJ, et al. Paper #332. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.

Disclosure:

Gholson reports no relevant financial disclosures. See the conference program guide for other authors’ disclosures.