title: Patient variables which may predict length of stay and hospital costs in elderly patients with hip fracture.
abstract: OBJECTIVE
  To investigate what factors contribute to increased length of stay (LOS) and increased costs in treatment of elderly patients with hip fractures.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  All patients who presented to a large tertiary care center between January 2000 and December 31, 2009.
  
  
  METHODS
  Charts for all patients older than 60 years who presented with isolated low-energy hip fractures were reviewed. Of the 719 patients identified, 660 were included.
  
  
  METHODS
  Patients who underwent operative fixation or hemiarthroplasty secondary to hip fracture were identified using a search of Current Procedural Terminology (CPT) codes search.
  
  
  METHODS
  Gender, height, weight, body mass index, length of procedure, American Society of Anesthesiologists (ASA) classification, and medical comorbidities were gathered and compared with LOS and direct daily inpatient hospital cost.
  
  
  RESULTS
  No correlation existed between body mass index or specific comorbidities and LOS, but ASA classification was a predictor. For each ASA increase of 1, average LOS increased 2.053 days (P < 0.001). Given total daily cost to the hospital for these patients was $4530, each increase in ASA classification translated to an increase of $9300.
  
  
  CONCLUSIONS
  ASA classification proved useful in estimating LOS and cost for patients undergoing operative fixation of hip fractures. Because ASA classification and cost are universally collected, this method can be employed in almost any hospital. This highlights a role for ASA classification in preoperative estimation of the elderly patient's cost and a potential advantage for incorporating patient factors in the development of tiered reimbursement models.
  
  
  METHODS
  Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors: Vanderbilt University School of Medicine, Nashville, TN 37221, USA.
authors: Anna E
authors: AE
authors: Garcia
authors: J V
authors: JV
authors: Bonnaig
authors: Zachary T
authors: ZT
authors: Yoneda
authors: Justin E
authors: JE
authors: Richards
authors: Jesse M
authors: JM
authors: Ehrenfeld
authors: William T
authors: WT
authors: Obremskey
authors: A Alex
authors: AA
authors: Jahangir
authors: Manish K
authors: MK
authors: Sethi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000191:economics* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D013714:Tennessee / Q000453:epidemiology; D014194:Traumatology / Q000191:economics* / Q000706:statistics & numerical data