A number of studies have reported longer length of hospital stay (LOS) after surgery in patients with higher ASA grades. The impact of Body Mass Index (BMI) on LOS after Total Hip Replacement (THR) remains unclear with conflicting findings in reported literature. In our hospital we strongly encourage all patients with a raised BMI to participate in a weight reduction programme prior to surgery. This prompted us to investigate the impact BMI has on LOS compared to the more established impact of ASA grade.

A retrospective analysis was conducted on all elective primary THR patients between 11/2013 to 02/2014. LOS in BMI groups <30, 30–39 and ≥40 and ASA grades 1–2 and 3–4 was compared. Where appropriate, independent t-test and non-parametric Mann-Whitney test were used to predict significance.

122 THR were analysed. Mean LOS in BMI groups <30, 30–39 and ≥40 were 5.6, 6.2 and 8.0 days, respectively. This was not predicted significant (p=0.7). Mean LOS in ASA groups 1–2 and 3–4 were 5.2 and 9.3, respectively. This was predicted significant (p-value < 0.01).

In patients undergoing primary THR, ASA grade is a better predictor of LOS than BMI. Our data adds to the evidence that high BMI alone is not a significant factor in prolonging LOS after a primary THR. This should be taken into account when allocating resources to optimise patients for surgery.

Introduction

We conducted an audit on hip fractures to analyse the accuracy of coding and payment by results in our institution.

Background

A large number of Tendo-Achilles (TA) injuries occur during sporting activity. Typically occurring in males aged 30–50, whom occasionally undertake sporting activities, the so called ‘weekend warriors’.