An evaluation of the accuracy and self-reported confidence of clinicians in using the ASA-PS Classification System

Silveira, Saullo Queiroz; Silva, Leopoldo Muniz da; Gomes, Ronald Figueiredo; Abib, Arthur de Campos Vieira; Vieira, Joaquim Edson; Ho, Anthony M.‐H.; Lima, Helidea de Oliveira; Bellicieri, Fernando Nardy; Camiré, Daenis; Nersessian, Rafael Sousa Fava; Mizubuti, Glenio B.

doi:10.1016/j.jclinane.2022.110794

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…If the measured values fall below the cut-off, the diagnosis is confirmed by evaluat- ing walking speed and grip strength according to the sarcopenia diagnostic criteria. [21][22][23] : This criterion focuses on evaluating the function of vital organs essential for sustaining life, including the heart, lungs, and kidneys. The assessment is conducted using the American Society of Anesthesiologists Physical Status Classification System (ASA-PS).…”

Section: Our Eligibility Criteriamentioning

confidence: 99%

Validating Hepatectomy Eligibility Criteria for Super Elderly Patients: A Retrospective Cohort Study

Koizumi,

Otsubo,

Kobayashi

et al. 2023

J St. Marianna Univ

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Background: In an aging population, hepatectomy, a highly invasive surgical procedure, is increasingly being performed on individuals aged 80 and above in Japan. However, there is a need to evaluate the effectiveness of the eligibility criteria used for patient selection and assess the surgical outcomes and risks associated with the procedure. Methods: This retrospective cohort study included 104 patients aged 80 years or older who met the lesion localization criteria for hepatectomy. The patients were divided into the hepatectomy group and the non-surgical group. Survival rates and postoperative complications were evaluated using Kaplan-Meier analysis and multivariate regression models. Results: The eligibility criteria effectively identified patients who were not suitable for hepatectomy, as evidenced by the survival outcomes of the non-surgery group. The hepatectomy group had a median overall survival of 59.3 months. Postoperative complications were observed in 21.4% of hepatectomy cases, with a mortality rate of 1.19%. Factors such as prealbumin and indocyanine green retention rate at 15 min were found to influence postoperative prognosis. Intraoperative bleeding volume was identified as a significant predictor of complications. Female patients had a lower rate of postoperative complications. Conclusion:The eligibility criteria for hepatectomy developed in this study were effective in identifying suitable candidates among super elderly patients aged 80 and above. Analysis of survival outcomes and factors affecting postoperative prognosis and complications provided valuable insights into surgical management in this specific patient population. Meticulous surgical technique and effective bleeding control strategies are crucial in minimizing the risk of complications. Further research and interventions focused on optimizing management of intraoperative bleeding may contribute to improved outcomes in hepatectomy patients. It is important to consider the limitations of this single-center study and conduct larger multi-center studies for generalizability.

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Section: Our Eligibility Criteriamentioning

confidence: 99%

Validating Hepatectomy Eligibility Criteria for Super Elderly Patients: A Retrospective Cohort Study

Koizumi,

Otsubo,

Kobayashi

et al. 2023

J St. Marianna Univ

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“…The impact of alcohol use in relation to the surgical outcome does not seem to differ among men and women and so far, about two drinks per day seems to be clinically accepted as the cut-off value. However, no safe use has been identified as reflected in the preoperative risk evaluation from the American Society of Anesthesiologists (ASA), which categorizes only persons with no or little alcohol use in the low-risk group [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of Alcohol Use Prior to Major Cancer Surgery: Timeline Follow Back Interview Compared to Four Other Markers

Nicklasson,

Sjödell,

Tønnesen

et al. 2024

Cancers

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Background: The postoperative complication rate is 30–64% among patients undergoing muscle-invasive and recurrent high-risk non-muscle-invasive bladder cancer surgery. Preoperative risky alcohol use increases the risk. The aim was to evaluate the accuracy of markers for identifying preoperative risky alcohol. Methods: Diagnostic test sub-study of a randomized controlled trial (STOP-OP trial), based on a cohort of 94 patients scheduled for major bladder cancer surgery. Identification of risky alcohol use using Timeline Follow Back interviews (TLFB) were compared to the AUDIT–C questionnaire and three biomarkers: carbohydrate-deficient transferrin in plasma (P–CDT), phosphatidyl-ethanol in blood (B–PEth), and ethyl glucuronide in urine (U–EtG). Results: The correlation between TLFB and AUDIT–C was strong (ρ = 0.75), while it was moderate between TLFB and the biomarkers (ρ = 0.55–0.65). Overall, sensitivity ranged from 56 to 82% and specificity from 38 to 100%. B–PEth showed the lowest sensitivity at 56%, but the highest specificity of 100%. All tests had high positive predictive values (79–100%), but low negative predictive values (42–55%). Conclusions: Despite high positive predictive values, negative predictive values were weak compared to TLFB. For now, TLFB interviews seem preferable for preoperative identification of risky alcohol use.

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“…Beyond the low reproducibility of the ASA score [ 6 , 7 ], the perioperative risk global assessment during the PAC is not well standardized and may be incomplete, especially when consultation time is limited. This is why in some anesthesia teams, patients are asked to complete a questionnaire in paper form before their PAC, allowing them to specify, for example, their past medical and surgical history or their usual treatments.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Risk Assessment of Patients Using the MyRISK Digital Score Completed Before the Preanesthetic Consultation: Prospective Observational Study

Ferré¹,

Laurent²,

Furelau³

et al. 2023

JMIR Perioper Med

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Background The ongoing COVID-19 pandemic has highlighted the potential of digital health solutions to adapt the organization of care in a crisis context. Objective Our aim was to describe the relationship between the MyRISK score, derived from self-reported data collected by a chatbot before the preanesthetic consultation, and the occurrence of postoperative complications. Methods This was a single-center prospective observational study that included 401 patients. The 16 items composing the MyRISK score were selected using the Delphi method. An algorithm was used to stratify patients with low (green), intermediate (orange), and high (red) risk. The primary end point concerned postoperative complications occurring in the first 6 months after surgery (composite criterion), collected by telephone and by consulting the electronic medical database. A logistic regression analysis was carried out to identify the explanatory variables associated with the complications. A machine learning model was trained to predict the MyRISK score using a larger data set of 1823 patients classified as green or red to reclassify individuals classified as orange as either modified green or modified red. User satisfaction and usability were assessed. Results Of the 389 patients analyzed for the primary end point, 16 (4.1%) experienced a postoperative complication. A red score was independently associated with postoperative complications (odds ratio 5.9, 95% CI 1.5-22.3; P=.009). A modified red score was strongly correlated with postoperative complications (odds ratio 21.8, 95% CI 2.8-171.5; P=.003) and predicted postoperative complications with high sensitivity (94%) and high negative predictive value (99%) but with low specificity (49%) and very low positive predictive value (7%; area under the receiver operating characteristic curve=0.71). Patient satisfaction numeric rating scale and system usability scale median scores were 8.0 (IQR 7.0-9.0) out of 10 and 90.0 (IQR 82.5-95.0) out of 100, respectively. Conclusions The MyRISK digital perioperative risk score established before the preanesthetic consultation was independently associated with the occurrence of postoperative complications. Its negative predictive strength was increased using a machine learning model to reclassify patients identified as being at intermediate risk. This reliable numerical categorization could be used to objectively refer patients with low risk to teleconsultation.

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An evaluation of the accuracy and self-reported confidence of clinicians in using the ASA-PS Classification System

Cited by 8 publications

References 25 publications

Validating Hepatectomy Eligibility Criteria for Super Elderly Patients: A Retrospective Cohort Study

Validating Hepatectomy Eligibility Criteria for Super Elderly Patients: A Retrospective Cohort Study

Identification of Alcohol Use Prior to Major Cancer Surgery: Timeline Follow Back Interview Compared to Four Other Markers

Perioperative Risk Assessment of Patients Using the MyRISK Digital Score Completed Before the Preanesthetic Consultation: Prospective Observational Study

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