Improving the Power of the American Society of Anesthesiology Classification System to Risk Stratify Vascular Surgery Patients Based on National Surgical Quality Improvement Project–Defined Functional Status

Kraev, Alexander I.; McGinn, Joseph T.; Etkin, Yana; Turner, James; Landis, Gregg

doi:10.1016/j.avsg.2018.04.005

Cited by 8 publications

(8 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ASA score physical status classification system is a system for assessing the fitness of patients before surgery. In 1963 the American Society of Anesthesiologists adopted the five-category physical status classification system; a sixth category was later added [4] [5] (Table 1).…”

Section: Data Analyticsmentioning

confidence: 99%

Future of Artificial Intelligence in Anesthetics and Pain Management

McGrath¹,

Flanagan²,

Zeng³

et al. 2019

JBM

View full text Add to dashboard Cite

The potential of the second wave of Artificial Intelligence (AI) to change our lives beyond recognition is both exciting and challenging. AI has been around for over three decades, and this new approach of artificial intelligence, due to enhancements in technology, both software, and hardware, has resulted in the fact that human decision-making is considered inferior and erratic in many fields: none more so than medicine. Machine learning algorithms with access to large data sets can be trained to outperform clinicians in many respects. AI's effectiveness in accurate diagnosis of various medical conditions and medical image interpretation is well documented. Modern AI technology has the potential to transform medicine to a level never seen before in terms of efficiency and accuracy; but is also potentially highly disruptive, creating insecurity and allowing the transfer of expert domain knowledge to machines. Anesthetics is a complex medical discipline and assuming AI can easily replace experienced and knowledgeable medical practitioners is a very unrealistic expectation. AI can be used in anesthetics to develop, in some respects, more advanced clinical decision support tools based on machine learning. This paper focuses on the complexity of both AI developments, deep learning, neural networks, etc. and opportunities of AI in anesthetics for the future. It will review current advances in AI tools and hardware technologies as well as outlining how these can be used in the field of anesthetics.

show abstract

Section: Data Analyticsmentioning

confidence: 99%

Future of Artificial Intelligence in Anesthetics and Pain Management

McGrath¹,

Flanagan²,

Zeng³

et al. 2019

JBM

View full text Add to dashboard Cite

show abstract

“…Intraoperative monitoring is essential to maintain the normal patient physiology and homeostasis throughout anaesthesia and surgery. The term "standard monitoring" defined by ASA refers to pulse oximeter, electrocardiography, noninvasive blood pressure and temperature monitoring [12].…”

Section: Anaesthesia Monitoring Using Artificial Intelligencementioning

confidence: 99%

Anaesthesia Monitoring using Artificial Intelligence Techniques

Harry¹,

Flanagan²,

Liaoyuan³

et al. 2019

Int J Anesthetic Anesthesiol

View full text Add to dashboard Cite

Artificial Intelligence (AI) will change our lives beyond recognition, it will have a far bigger impact than the internet or mobile technology. We are now at the threshold where machine intelligence is comparable with human intelligence, in certain limited aspects, for the first time in history. Enhancements in technology, both software and hardware, have resulted in some human decision-making being inferior to, and more erratic than, AI in many fields, including medicine. However, it is widely accepted that rather than compete with machines, using AI to support and help make better informed decisions is the key to future medicine. In areas like anaesthesia, AI can be used to develop useful advanced clinical decision support tools based on machine learning.

show abstract

“…ASA-Physical Status is associated with postoperative morbidity and mortality, and this specifically influences anesthetic management (eg, moderate or deep sedation, general anesthesia). 12,13 ASA-Physical Status classification allows a simple and overall evaluation of comorbidities by a single and reproducible score, some of which have been individually described as risk factors for vascular graft and endograft infection. 11 The ASA-Physical Status as a risk factor for SSI has been studied in non-peripheral vascular surgery and it is used in the National Nosocomial Infections Surveillance (NNIS) index.…”

mentioning

confidence: 99%

American Society of Anesthesiologists-Physical Status Classification As An Independent Risk Factor of Surgical Site Infection After Infra-Inguinal Arterial Bypass

et al. 2023

View full text Add to dashboard Cite

Objectives: The present study aimed to assess whether high-risk American Society of Anesthesiologists (ASA)-Physical Status was an independent risk factor for the development of surgical site infection (SSI) after infra-inguinal lower extremity bypass (LEB). Summary of Background Data: The ASA-Physical Status Classification System assesses the overall physical status preoperatively. ASA-Physical Status is associated with postoperative morbidity and mortality. However, limited data are available on how ASA-Physical Status Class affects the development of SSI after infra-inguinal LEB. Methods: Patients who had undergone infra-inguinal LEB from January 1, 2015 to December 31, 2018, for obliterative arteriopathy or popliteal aneurysm at our university hospital were included. SSI risk factors were identified using multivariable logistic regression. The length of hospital stay, major limb events (MALE), major adverse cardiovascular events (MACE), and all-cause mortality were compared for patients with SSI versus those without SSI 3 months and 1- year of follow-up after the index surgery. Results: Among the 267 patients included, 30 (11.2%) developed SSI during the 3-month period and 32 (12%) at 1 year. ASA-Physical Status ≥3 [odds ratio (OR): 3.7, 95% confidence interval CI) 1.5–11.1], emergency surgery (OR: 2.7, 95% CI 1.2–6.0), general anesthesia (OR: 2.8, 95% CI 1.3–6.1), and procedure performed by a junior surgeon (OR: 2.7, 95% CI 1.3–6.0) were independently associated with SSI. At 3 months and 1 year, SSI was significantly associated with MALE (including surgical wound debridement, subsequent thrombectomy, major amputation), length of hospital stay, and all-cause mortality. Conclusion: The ASA-Physical Status should be considered in medical management when an infra-inguinal LEB is considered in frail patients, to prevent surgical complications.

show abstract

Improving the Power of the American Society of Anesthesiology Classification System to Risk Stratify Vascular Surgery Patients Based on National Surgical Quality Improvement Project–Defined Functional Status

Cited by 8 publications

References 26 publications

Future of Artificial Intelligence in Anesthetics and Pain Management

Future of Artificial Intelligence in Anesthetics and Pain Management

Anaesthesia Monitoring using Artificial Intelligence Techniques

American Society of Anesthesiologists-Physical Status Classification As An Independent Risk Factor of Surgical Site Infection After Infra-Inguinal Arterial Bypass

Contact Info

Product

Resources

About