ASA classification and perioperative variables as predictors of postoperative outcome.
01 Aug 1996-BJA: British Journal of Anaesthesia (Oxford University Press)-Vol. 77, Iss: 2, pp 217-222
TL;DR: It is concluded that ASA physical status classification was a predictor of postoperative outcome using both univariate analysis and calculation of the odds ratio of the risk of developing a postoperative complication by means of a logistic regression model.
Abstract: In a prospective study of 6301 surgical patients in a university hospital, we examined the strength of association between ASA physical status classification and perioperative risk factors, and postoperative outcome, using both univariate analysis and calculation of the odds ratio of the risk of developing a postoperative complication by means of a logistic regression model. Univariate analysis showed a significant correlation (P
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TL;DR: A 2-part systematic review to guide clinicians on clinical and laboratory predictors of perioperative pulmonary risk before noncardiothoracic surgery and to evaluate the efficacy of strategies to reduce the risk for postoperative pulmonary complications is prepared.
Abstract: This background review supports the American College of Physicians' clinical practice guideline on risk assessment for postoperative pulmonary complications after noncardiothoracic surgery.
860 citations
TL;DR: From the Departments of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, and Clinical Epidemiology, Biostatistics, and Bioinformatics (M.G.G., M.J.L.B.), Surgery (D.A.B., O.R.R.), Radiology (Y.N.N., J.S.R., K.H.R.)
Abstract: From the Departments of Gastroenterology and Hepatology (D.L.C., E.A.J.R., K.H., M.J.B.), Surgery (D.J.G., M.A.B., O.R.B.), Radiology (Y.N., J.S., J.S.L.), and Clinical Epidemiology, Biostatistics, and Bioinformatics (M.G.W.D.), Academic Medical Center, Amsterdam. Address reprint requests to Dr. Cahen at the Department of Gastroenterology and Hepatology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands, or
609 citations
TL;DR: The current knowledge and evaluation regarding ASA Classification of Physical Health as well as trials for possible modification are reviewed.
Abstract: Although the American Society of Anaesthesiologists' (ASA) classification of Physical Health is a widely used grading system for preoperative health of the surgical patients, multiple variations were observed between individual anaesthetist's assessments when describing common clinical problems. This article reviews the current knowledge and evaluation regarding ASA Classification of Physical Health as well as trials for possible modification.
600 citations
TL;DR: The cardiac risk calculator provides a risk estimate of perioperative myocardial infarction or cardiac arrest and is anticipated to simplify the informed consent process and its predictive performance surpasses that of the Revised Cardiac Risk Index.
Abstract: Background—Perioperative myocardial infarction or cardiac arrest is associated with significant morbidity and mortality. The Revised Cardiac Risk Index is currently the most commonly used cardiac r...
555 citations
TL;DR: In this paper, the authors compare the incidence of newly developed chronic renal insufficiency after partial nephrectomy (PN) and radical neutropenectomy (RN).
508 citations
References
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TL;DR: The form and validation results of APACHE II, a severity of disease classification system that uses a point score based upon initial values of 12 routine physiologic measurements, age, and previous health status, are presented.
Abstract: This paper presents the form and validation results of APACHE II, a severity of disease classification system. APACHE II uses a point score based upon initial values of 12 routine physiologic measurements, age, and previous health status to provide a general measure of severity of disease. An increasing score (range 0 to 71) was closely correlated with the subsequent risk of hospital death for 5815 intensive care admissions from 13 hospitals. This relationship was also found for many common diseases. When APACHE II scores are combined with an accurate description of disease, they can prognostically stratify acutely ill patients and assist investigators comparing the success of new or differing forms of therapy. This scoring index can be used to evaluate the use of hospital resources and compare the efficacy of intensive care in different hospitals or over time.
14,583 citations
TL;DR: The ASA Physical Status Classification is useful but suffers from a lack of scientific precision.
Abstract: The American Society of Anesthesiologists' (ASA) Physical Status Classification was tested for consistency of use by a questionnaire sent to 304 anesthesiologists. They were requested to classify ten hypothetical patients. Two hundred fifty-five (77.3 percent) responded to two mailings. The mean number of patients rated consistently was 5.9. Four patients elicited wide ranges of responses. Age, obesity, previous myocardial infarction, and anemia provoked controversy. There was no significant difference in responses from different regions of the country. Academic anesthesiologists rated a greater number identical than did those in private practice (P less than 0.01). There was no difference in ratings between those who used the classification for billing purposes and those who did not. The ASA Physical Status Classification is useful but suffers from a lack of scientific precision.
1,857 citations
"ASA classification and perioperativ..." refers background in this paper
...A major drawback of the ASA system is assessment of a patient’s “correct” ASA classification by different anaesthetists and this was shown clearly by Owens, Felt and Spitznagel [14]....
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TL;DR: The scoring system produced assessments for morbidity and mortality rates which did not significantly differ from observed rates and the present paper attempts to validate it prospectively.
Abstract: POSSUM, a Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity, is described. This system has been devised from both a retrospective and prospective analysis and the present paper attempts to validate it prospectively. Logistic regression analysis yielded statistically significant equations for both mortality and morbidity (P less than 0.001). When displayed graphically zones of increasing morbidity and mortality rates could be defined which could be of value in surgical audit. The scoring system produced assessments for morbidity and mortality rates which did not significantly differ from observed rates.
1,579 citations
"ASA classification and perioperativ..." refers background or methods or result in this paper
...This was done as a means of eliminating the interference of these variables, as in previous studies [9, 12, 13]....
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...To assess the role of the complexity of an operation as an independent risk factor, previous studies divided the interventions into two groups (minor/major) [9], or into four groups (minor/moderate/major/major ) [13]....
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...The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) was presented by Copeland, Jones and Walters in 1991 [13] and is based on a point score derived from 12 physiological and six operative severity score factors....
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1,565 citations
"ASA classification and perioperativ..." refers background or methods in this paper
...The ASA classification has established itself as the most widely used patient risk assessment scheme in anaesthesia, despite being developed in 1941 by Saklad [1] for the purpose of statistical data management....
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...The American Society of Anesthesiologists’ (ASA) classification of physical status was introduced in 1941 by Saklad [1] in an attempt to provide a basis for comparison of statistical data in anaesthesia....
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