The Association of ASA Score and Outcomes Following Total Ankle Arthroplasty

BACKGROUND This study seeks to evaluate the relationship between American Society of Anesthesiologist (ASA) score and postoperative outcomes following TAA. METHODS The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried from 2007-2020 to identify 2,210 TAA patients. Patients were stratified into low (n=1328; healthy/mild systemic disease) or high (n=881; severe/life-threatening systemic disease) ASA score cohorts. RESULTS There was no statistically significant difference in complications, readmission, or reoperation rate based on ASA score. Increased ASA score was significantly associated with longer length of stay (low =1.69 days, high =1.98 days; p<.001) and higher rate of adverse discharge (low =95.3%, high =87.4%; p<.001). CONCLUSION Higher ASA scores (3 and 4) were statically significantly associated with increased length of stay and non-home discharge disposition. These findings are valuable for physicians and patients to consider prior to TAA given the increased utilization of resources and cost associated with higher ASA scores. Level of Evidence Level III, Retrospective cohort study