Comparison of two preoperative indices to predict perioperative mortality in non-cardiac thoracic surgery

Abstract

The subjective assessment by an experienced anesthesiologist as expressed by the ASA-score is a valid method in the determination of the perioperative risk. CRI does not contribute additional information for the general perioperative risk.

Complications for Radical Cystectomy

“…Indeed, 15.7% of the patients with poor ASA score presented with diversion related fistulas, the most frequent complications in this series and those with the most significant impact on hospital stay (29–35 additional days). This was not unexpected as the relevance of the subjective assessment by experienced anesthesiologists in the determination of perioperative risks has been repeatedly confirmed in various types of major surgical procedures such as thoracic surgery [3]and major gastrointestinal surgery [4, 5, 6]. We suggest that cystectomy patients with ASA scores of three or above should be subjected to further preoperative evaluation focusing on parameters that could be improved or corrected.…”

The Surgical Mortality Probability Model

“…The relationship between ASA PS and mortality was recognized early on by Dripps and colleagues 19 and by other investigators. [20][21][22]31,32 Despite this finding, the ASA PS was never designed to "prognosticate the effect of a surgical procedure." 33 Yet, 7 decades after it was introduced, 33 the ASA PS remains one of the most important single predictors of mortality and morbidity for general surgery.…”

A cross-sectional survey of Australian anesthetists’ and surgeons’ perceptions of preoperative risk stratification and prehabilitation

“…Studies have shown correlations between the ASA-PS in postoperative outcomes such as infection, anastomotic failure, pulmonary complications, length of stay, and mortality. In a range of surgical cohorts including orthopedic, gastrointestinal, gynecologic, and thoracic, [49][50][51][52][53][54][55] the ASA score is simple and can be performed rapidly at the bedside, but it carries significant inter-rater variation and is therefore thought to lack discriminatory power 56 compared with more complex but informative risk scores. 57…”