The ASA Physical Status Classification: What Is the Evidence for Recommending Its Use in Veterinary Anesthesia?—A Systematic Review

Abstract

Background: The effectiveness of the American Society of Anesthesiologists (ASA) Physical Status (PS) classification to identify the animals at a greater risk of anesthesia-related death and complications is controversial. In this systematic review, we aimed to analyze studies associating the ASA PS scores with the outcome of anesthesia and to verify whether there was any evidence for recommending the use of the ASA PS in veterinary patients.Methods: Research articles found through a systematic literature search were assessed for eligibility, and data were extracted and analyzed using random-effects analysis.Results: A total of 15 observational prospective and retrospective studies including 258,298 dogs, cats, rabbits, and pigs were included. The analysis found consistency between the studies showing that dogs, cats and rabbits with an ASA-PS ≥III had 3.26 times (95% CI = 3.04–3.49), 4.83 times (95% CI = 3.10–7.53), and 11.31 times (95% CI = 2.70–47.39), respectively, the risk of anesthesia-related death within 24 h (dogs) and 72 h (cats and rabbits) after anesthesia compared with those with an ASA PS <III. In addition, the analysis showed that dogs and cats with ASA PS ≥III had 2.34 times the risk of developing severe hypothermia during anesthesia (95% CI = 1.82–3.01).Conclusions: The simple and practical ASA PS was shown to be a valuable prognostic tool and can be recommended to identify an increased risk of anesthetic mortality until 24–72 h after anesthesia, and a greater risk of development severe intraoperative hypothermia.

Publication Rate and Evidence-Based Evaluation of Abstracts Presented at the Annual Veterinary Orthopedic Society Conference

“…5,8 Currently, there are multiple grading schemes available with no clear consensus in veterinary medicine regarding the best method to critically evaluate clinical studies. 5,[10][11][12][13][14][15][16] Therefore, it is possible that use of an alternative system may have provided different results than those reported in this study. The Oxford Centre for Evidence-Based Medicine (OCEBM) attempts to provide an objective measure for evaluating LoE based on study design.…”

Deutschlandweite Studie zur präanästhetischen Risikoeinschätzung mithilfe der ASA-Klassifikation beim Hund

“…Die Einschätzung des Patienten und Einteilung in eine der 5 Gruppen erfolgt rein subjektiv und daher möglicherweise durch jeden Anwender unterschiedlich. So konnten durch Studien in der Humanmedizin teils massive Abweichungen bei Vergabe der ASA-Klassen nachgewiesen werden [12] [22]. In der humanmedizinischen Studie von Lienhart et al [21] wiesen Patienten der ASA-Klassen 1 und 2 ein durchschnittliches Mortalitätsrisiko von 0,4-5 Todesfällen/100 000 Anästhesien auf, Patienten in den Gruppen 3 und 4 dagegen ein Mortalitätsrisiko von 27-55 Todesfällen/100 000 Anästhesien.…”

“…Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.Auch Portier et al[22] konnten für den Hund einen direkten Zusammenhang zwischen steigender perioperativer Mortalität und steigender ASA-Klasse nachweisen: Das Risiko, perioperativ zu versterben, war bei Hunden der ASA-Klasse 3 ca. 3-fach und bei Tieren der ASA-Klasse 5 sogar ca.…”

Risk factors for postoperative urinary retention among women who underwent laparoscopic cholecystectomy

“…The study subjects were 591 female patients who underwent laparoscopic cholecystectomy for the treatment of gallbladder stones between March 2014 and February 2018. Electronic medical records were retrospectively reviewed, and information on body mass index (BMI), creatinine, absolute neutrophil count (ANC), duration of the operation and anesthesia, the amount of fluid infused, American Society of Anesthetists (ASA) classification, and medical comorbidities (e.g. hypertension, diabetes, and liver, lung, heart, renal, and neurological disease) was extracted.…”