Assessment of the Inter-Individual Concordance of ASA PS Score versus ABCK: A Survey Carried Out Among Anaesthetists of Kinshasa City

Abstract

Background: The ASA PS is a score which evaluates the physical state of a preoperative patient. It is largely used throughout the world. However, it is subjective and presents inconsistencies among anaesthetists. Because of these disagreements, some medical institutions established their own methods of evaluation. One of them is the Altered general status-Breathing-Circulation-K scores (ABCK). The question which this study raised was to know whether, in terms of inter individual consistency, the ABCK, a new score which has presented an excellent agreement with the ASA PS, could not be more effective than the ASA PS? Methods: A survey of the ASA PS and ABCK classes of ten hypothetical cases from the Aronson study (2) and the reasons for their choice, was carried out among anesthetists in Kinshasa. The sampling was of the exhaustive type. The data were collected using a self-administered questionnaire technique. Results: This study showed that the agreement between the two scores varied from a weak agreement (kappa de Cohen = 0.2; p = 0.001) to a moderate agreement (Kappa de Cohen = 0.59; p = 0.001). Furthermore, the ABCK had an interindividual interclass variance weaker than the ASA PS (IC 95 %; P< 0.005). Conclusion: The ABCK score proves to be much more objective than the ASA PS. Indeed, it has an interclass variability weaker than that of the ASA PS. And because of its good agreement with the ASA PS, it could be used as an alternative or complement to it.