The ASA Classification of Physical Status–A Recapitulation

Tibial Tubercle Osteotomy or Quadriceps Snip in Two-stage Revision for Prosthetic Knee Infection? A Randomized Prospective Study

“…A diagnosis of chronic prosthetic knee infection, at more than 6 weeks after TKA, [8,40,54,71,77,93], defined by at least three of the following, was the inclusion criteria (Table 1): (1) unexplained pain with no radiographic evidence of implant malpositioning; (2) 10 mg/L or greater C-reactive protein (CRP) without preexisting inflammatory joint disease [4,75,86]; (3) 30 mm/hour or greater erythrocyte sedimentation rate (ESR) without preexisting inflammatory joint disease [4,75,86]; (4) radiographic implant loosening and/or periosteal osteogenesis and/or progressive nonfocal osteolysis without implant malpositioning [90]; (5) sinus or fistula communicating with prosthesis; (6) abnormal leukocytes labeled technetium-99 m bone scan (LeukoScan 1 , Immunomedics GmbH, Darmstadt, Germany) [61]; (7) a positive culture of synovial fluid collected preoperatively; (8) five or more polymorphonuclear cells in at least five highpower fields in periprosthetic tissue samples, collected on removal of primary implant [9,32,91]; (9) a positive synovial fluid cell count (more than 2000 polymorphonuclear cells with greater than 64% polymorphonuclear leukocytes) without preexisting inflammatory joint disease [75,91]. A high American Society of Anesthesiologists (ASA) score [59] excluded four patients. They were treated with antibiotics and pain management.…”

Early postoperative emergencies requiring an intensive care team interventionThe role of ASA physical status and after‐hours surgery

“…The independent risk factors of severe complications, death or coma within 24 h of anaesthesia include patient's age, number of associated diseases, pre-operative status, emergency surgery and the duration of procedure [21]. While the ASA physical status was not originally intended to be used as an estimate of 'operative risk' [24], it is a predictor of postoperative outcome [25]. After-hours procedures are usually performed by junior trainee surgeons and this was a factor associated with peri-operative deaths in an early Confidential Enquiry into Perioperative Deaths (CEPOD) study [26].…”

Safety and Prevention of Complications in Endoscopic Sedation

“…The four deaths in this large cohort of patients occurred in patients with American Society of Anesthesiologists (ASA) [21] statuses of 3 or higher who were undergoing non-routine medical procedures, and three of the patients had serious underlying illnesses. These results indicate that the safety of propofol administration by endoscopists is comparable or superior to the published safety records of opioids and benzodiazepines administered by endoscopists for GI endoscopy [5][6][7][8].…”