scholarly journals Updated classification of the physical condition of patients of the american society of anesthesiologists

2021 ◽  
Vol 15 (2) ◽  
pp. 101-106
Author(s):  
Victor A. Koriachkin ◽  
Yaakov I. Levin ◽  
Dmitry V. Zabolotskii ◽  
Vladimir V. Khinovker ◽  
Rustam Р. Safin
Keyword(s):  
Significant Role ◽  
Physical Condition ◽  
Clinical Samples ◽  
Physical Status ◽  
Asa Classification ◽  
Preoperative Status ◽  
American Society ◽  
American Society Of Anesthesiologists

The American Society of Anesthesiologists (ASA) Classification of Physical Status is a widely used system for assessing the preoperative status of patients. The ASA class definitions have been amended several times since 1941, which caused some difficulties in using the classification. There are some difficulties in the assessments, especially between the III and IIIII classes of the ASA. To overcome this problem, clinical samples presented in the latest edition of the classification play a significant role. In this article, we have presented an updated classification of the physical condition of patients on the ASA scale before anesthesia and surgery, which is sufficiently simple, reproducible, and can be successfully used not only in adults, but also in pediatric and obstetric anesthesiology.

ASA classification – What is the real impact of the introduction of the new clinical examples?

2018 ◽  
Vol 29 (7-8) ◽  
pp. 203-209
Author(s):  
Pedro Godinho ◽  
Lúcia Gonçalves ◽  
Paulo Muendane ◽  
Maria dos Anjos Dixe ◽  
Elisabete Valente
Keyword(s):  
Physical Status ◽  
Online Questionnaire ◽  
The Real ◽  
Asa Classification ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Universal Scale ◽  
Level Of Agreement ◽  
High Diversity

Aim The American Society of Anesthesiologists scale is used worldwide for the assessment of the physical status of patients proposed for anaesthesia interventions. This study aims to assess the level of agreement of the last updated American Society of Anesthesiologists classification version, with the introduction of examples for each class, and search for variables that could promote inconsistency. Methods An online questionnaire was sent to anaesthesiology specialists and residents in Portugal, describing 10 fictitious clinical cases. Sociodemographic and labour data were also correlated. Results/findings: A total of 243 anaesthesiology physicians participated. There was a high diversity in responses. Years of practice influence this diversity (P < 0.05). Discussion and conclusions: The need for a universal scale for classification of patients proposed for anaesthesia is consensual. Despite the last update in 2014, the American Society of Anesthesiologists classification continues to present limitations regarding consistency and objectivity. Efforts should be made to reduce their interpersonal variability.

scholarly journals Development and validation of a predictive model for American Society of Anesthesiologists Physical Status

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seshadri C. Mudumbai ◽  
Suzann Pershing ◽  
Thomas Bowe ◽  
Robin N. Kamal ◽  
Erika D. Sears ◽  
...  
Keyword(s):  
Predictive Validity ◽  
Research Quality ◽  
Multinomial Regression ◽  
Physical Status ◽  
Improvement Program ◽  
Variable Model ◽  
Preoperative Status ◽  
American Society ◽  
Key Indicators ◽  
American Society Of Anesthesiologists

Abstract Background The American Society of Anesthesiologists Physical Status (ASA-PS) classification system was developed to categorize the fitness of patients before surgery. Increasingly, the ASA-PS has been applied to other uses including justification of inpatient admission. Our objectives were to develop and cross-validate a statistical model for predicting ASA-PS; and 2) assess the concurrent and predictive validity of the model by assessing associations between model-derived ASA-PS, observed ASA-PS, and a diverse set of 30-day outcomes. Methods Using the 2014 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use Data File, we developed and internally cross-validated multinomial regression models to predict ASA-PS using preoperative NSQIP data. Accuracy was assessed with C-Statistics and calibration plots. We assessed both concurrent and predictive validity of model-derived ASA-PS relative to observed ASA-PS and 30-day outcomes. To aid further research and use of the ASA-PS model, we implemented it into an online calculator. Results Of the 566,797 elective procedures in the final analytic dataset, 8.9% were ASA-PS 1, 48.9% were ASA-PS 2, 39.1% were ASA-PS 3, and 3.2% were ASA-PS 4. The accuracy of the 21-variable model to predict ASA-PS was C = 0.77 +/− 0.0025. The model-derived ASA-PS had stronger association with key indicators of preoperative status including comorbidities and higher BMI (concurrent validity) compared to observed ASA-PS, but less strong associations with postoperative complications (predictive validity). The online ASA-PS calculator may be accessed at https://s-spire-clintools.shinyapps.io/ASA_PS_Estimator/ Conclusions Model-derived ASA-PS better tracked key indicators of preoperative status compared to observed ASA-PS. The ability to have an electronically derived measure of ASA-PS can potentially be useful in research, quality measurement, and clinical applications.

AMERICAN SOCIETY OF ANESTHESIOLOGISTS CLASSIFICATION OF PHYSICAL STATUS AS A PREDICTOR OF WOUND INFECTION

2007 ◽  
Vol 77 (9) ◽  
pp. 738-741 ◽  
Author(s):  
John C. Woodfield ◽  
Nagy M. Y. Beshay ◽  
Ross A. Pettigrew ◽  
Lindsay D Plank ◽  
Andre M. van Rij
Keyword(s):  
Wound Infection ◽  
Physical Status ◽  
American Society ◽  
American Society Of Anesthesiologists

scholarly journals Classification of Patients According to the Degree of Dependence on Nursing Care and Illness Severity in a Post-Anesthesia Care Unit

2010 ◽  
Vol 18 (5) ◽  
pp. 881-887 ◽  
Author(s):  
Luciana Bjorklund de Lima ◽  
Deise Borges ◽  
Samara da Costa ◽  
Eneida Rejane Rabelo
Keyword(s):  
Nursing Care ◽  
Cross Sectional Study ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Cross Sectional ◽  
Asa Classification ◽  
Anesthetic Risk ◽  
American Society ◽  
American Society Of Anesthesiologists

This study aimed to classify patients according to their degree of dependence on nursing care (Perroca Classification System) and correlate this with the anesthetic risk (American Society of Anesthesiologists - ASA classification) in a post-anesthesia care unit. A cross-sectional study was conducted, which included 402 patients, mean age 51.57 (±16.73) years, of which 216 (54%) were female. The results indicate that patients had a degree of dependence between intermediate and semi-intensive with an ASA classification of between two and three. There was a significant relationship between degree of dependence and ASA classification. The results indicate that the post-anesthesia care unit admits patients with semi-intensive care requirements and with moderate anesthetic risk.

scholarly journals Epidural Anaesthesia Saved A Patient With Multiple Co-Morbid Condition

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 729-730
Author(s):  
Rahena Khatun ◽  
Md Zulfikar Ali
Keyword(s):  
Epidural Anaesthesia ◽  
Postoperative Recovery ◽  
Morbid Condition ◽  
Physical Status ◽  
Uncontrolled Diabetes ◽  
Life Saving ◽  
Diabetic Gangrene ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Morbid Conditions

Epidural anaesthesia has been routinely used for many years and widely accepted as an effective mathod of pain relief . The procedure is commonly performed as a sole anaesthesic or in combination with spinal or general anaesthesia. In our case Md. Alauddin, 59 years old male was admitted in KYAMCH with complaints of diabetic gangrene of right foot with features of septicemia and he has a long history uncontrolled diabetes mellitus and hypertension leading to developed ischemia heart disease and CRF. After proper evaluation patient's physical status was graded as ASA (American society of Anesthesiologists) class-IV, and selected for above knee amputation of right lower limb but patient was unfit for anesthesia due to his co morbid conditions. As a life saving procedure the operation was done under epidural anesthesia and per- operative and postoperative recovery was uneventful.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 729-730

scholarly journals Discordant American Society of Anesthesiologists Physical Status Scoring between Anesthesiologists and Surgeons Is Correlated With Adverse Patient Outcomes: A Retrospective Cohort Study of 46284 Elective Surgical Patients

2021 ◽  
Author(s):  
Charlene Xian Wen Kwa ◽  
Jiaqian Cui ◽  
Daniel Yan Zheng Lim ◽  
Yilin Eileen Sim ◽  
Yuhe Ke ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patient Outcomes ◽  
Real World ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Clinical Factors ◽  
Physical Status ◽  
Asa Score ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract BackgroundThe American Society of Anesthesiologists Physical Status Classification (ASA) score is used for communication of patient health status, risk scoring, benchmarking and financial claims. Prior studies using hypothetical scenarios have shown poor concordance of ASA scoring among healthcare providers. However, there is a paucity of concordance studies using real-world data, as well as studies of clinical factors or patient outcomes associated with discordant scoring. The study aims to assess real-world ASA score concordance between surgeons and anesthesiologists, factors surrounding discordance and its impact on patient outcomes. MethodsThis retrospective cohort study was conducted in a tertiary academic medical center on 46284 consecutive patients undergoing elective surgery between January 2017 and December 2019. ASA scores entered by surgeons and anesthesiologists, patient demographics, and post-operative outcomes were collected. We assessed the concordance of preoperative ASA scoring between surgeons and anesthesiologists, clinical factors associated with score discordance, the impact of score discordance on clinically important outcomes, and the discriminative ability of the two scores for 30-day mortality, 1-year mortality, and intensive care unit (ICU) admission. Statistical tests used included Cohen’s weighted 𝜅 score, chi-square test, t-test, unadjusted odds ratios and logistic regression models. ResultsThe ASA score showed moderate concordance (weighted Cohen’s 𝜅 0.53) between surgeons and anesthesiologists. 15098 patients (32.6%) had discordant scores, of which 11985 (79.4%) were scored lower by surgeons. We found significant associations between discordant scores and anesthesiologist-assessed comorbidities, patient age and race. Patients with discordant scores had a higher risk of 30-day mortality (odds ratio 2.00, 95% confidence interval [CI] = 1.52-2.62, p<0.0001), 1-year mortality (odds ratio 1.53, 95% CI = 1.38-1.69, p < 0.0001), and ICU admission >24 hours (odds ratio 1.69, 95% CI = 1.47-1.94, p< 0.0001), and stratified analyses showed a trend towards higher risk when the surgeons’ ASA score was lower. ConclusionsThere is moderate concordance between surgeons and anesthesiologists in assigning the ASA classification. Discordant ASA scores are associated with adverse patient outcomes. Hence, there is a need for improved standardization of ASA scoring and cross-specialty review in ASA-discordant cases.

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