Abstract
Introduction
We conducted a study of 312 patients undergoing primary hip and knee arthroplasty in 2005. The aim was to identify the correlation between length of stay, ASA (American society of Anaesthesiologist) grade and BMI (Body Mass Index).
Method and materials
312 patients underwent hip and knee arthroplasty in 2005. ASA grade for surgery was documented by the anaesthetist and BMI by the nurses. 67 patients had inadequate documentation. SPSS software was used for analysis.
Results
Of the 245 patients; 35 had ASA grade 1, 144 had ASA grade 2, 64 had ASA grade 3 and 2 had ASA grade 4.
Mean length of stay for ASA grade 1 was 6.8 days, ASA grade 2 was 9.75 days, ASA grade 3 was 12.5 days and ASA grade 4 was 13.5 days. There was significant positive correlation (p < 0.01) between the ASA grade and post-operative length of stay. BMI was graded as I (<18.5), II (18.5-24.9), III (25-29.9) and IV (>30). There was no correlation (Pearson's correlation coefficient = 0.184) between BMI and post-operative length of stay.
Conclusion
As the ASA grade increases the length of stay in hospital increases. ‘Cherry picking’ of ASA grade I and II patients by the ISTC will increase the average length of stay in NHS hospitals resulting in increased cost. Length of stay on its own is not a good indicator of hospital performance.
