Association of Postoperative Outcomes with the Pre-op Categorization Based on the American Society of Anesthesia Class in Emergency General Surgery Patients
DOI:
https://doi.org/10.47489/szmc.v38i3.535Keywords:
Outcomes, morbidity, American Society of Anaesthesiologists, Risk stratificationAbstract
Introduction: Emergency general surgery patients are at higher risk of postoperative complications and mortality compared to elective surgery patients. The American Society of Anaesthesiologists’ (ASA) classification system is a tool for assessing the pre-operative co-morbidity status and predicting peri-operative risk and mortality.
Aims & Objectives: This study aimed to evaluate the association between ASA class and postoperative outcomes in emergency general surgery patients.
Place and Duration of Study: Hayatabad Medical Complex, MTI, Peshawar, from September 2022 to March 2023. Materials & Methods: This cross-sectional study involved 192 emergency general surgery patients enrolled through a non-probability, consecutive sampling technique. ASA class using the ASA scoring system, demographic data, comorbidities, and postoperative outcomes (including cardiac complications, surgical site infections, readmissions, and mortality) were recorded. Statistical analysis was conducted using SPSS version 23, with a significance level set at p ? 0.05.
Results: Patients were classified into ASA classes I to IV, with varying rates of comorbidities and postoperative outcomes across the groups. Significant associations were observed between ASA class and cardiac complications (p = 0.008), surgical site infections (p = 0.038), and mortality (p = 0.001). However, no significant association was found for venous thromboembolism (p = 0.127) or readmissions (p = 0.465).
Conclusion: ASA class is significantly associated with postoperative outcomes, including cardiac complications, surgical site infections, and mortality, in emergency general surgery patients. While venous thromboembolism and readmissions did not show significant associations, higher ASA classes still indicated a greater risk.
References
Sun M, Xu M, Sun J. Risk factor analysis of postoperative complications in patients undergoing
emergency abdominal surgery. Heliyon. 2023 Mar 1;9(3).
Dosis A, Helliwell J, Syversen A, Tiernan J, Zhang Z, Jayne D. Estimating postoperative mortality in colorectal surgery- a systematic review of risk prediction models. Int J Colorectal Dis. 2023 Jun 1;38(1):155.
Kuiper BI, Janssen LMJ, Versteeg KS, Ten Tusscher BL, van der Spoel JI, Lubbers WD, et al. Does preoperative multidisciplinary team assessment of high-risk patients improve the safety and outcomes of patients undergoing surgery? . BMC Anesthesiol. 2024 Jan 2;24(1):9.
Stones J, Yates D. Clinical risk assessment tools in anaesthesia. Bja Education. 2019 Feb;19(2):47.
Li G, Walco JP, Mueller DA, Wanderer JP, Freundlich RE. Reliability of the ASA physical status classification system in predicting surgical morbidity: a retrospective analysis. Journal of Medical Systems. 2021 Sep;45:1-8.
Olters UW, Wolf T, Stützer H, Schröder T. ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth. 1996;77:217-22.
Kwa CX, Cui J, Lim DY, Sim YE, Ke Y, Abdullah HR. Discordant American Society of Anesthesiologists Physical Status Classification between anesthesiologists and surgeons and its correlation with adverse patient outcomes. Scientific Reports. 2022 May 2;12(1):7110.
Doyle DJ, Goyal A, Bansal P, Garmon EH. American Society of Anesthesiologists Classification. In: StatPearls. StatPearls Publishing LLC; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441940/
Raffee L, Almasarweh SA, Mazahreh TS, Alawneh K, Alabdallah NB, Al Hamoud MA, et al. Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS). BMJ Open. 2022 Nov 18;12(11):e061781.
Ylimartimo AT, Nurkkala J, Koskela M, Lahtinen S, Kaakinen T, Vakkala M, Hietanen S, Liisanantti J. Postoperative Complications and Outcome After Emergency Laparotomy: A Retrospective Study. World J Surg. 2023 Jan;47(1):119-129
Shah AA, Latif A, Zogg CK, Zafar SN, Riviello R, Halim MS, Rehman Z, Haider AH, Zafar H. Emergency general surgery in a low-middle income health care setting: Determinants of outcomes. Surgery. 2016 Feb;159(2):641-9.
Sultan, R., Zafar, H. (2018). Improving outcomes of emergency bowel surgery using NELA model. Journal of the College of Physicians and Surgeons Pakistan, 28(2), 150-154.
Sharoky CE, Bailey EA, Sellers MM, Kaufman EJ, Sinnamon AJ, Wirtalla CJ, Holena DN, Kelz RR. Outcomes of hospitalized patients undergoing
emergency general surgery remote from admission. Surgery. 2017 Sep 1;162(3):612-9.
Meyer AC, Eklund H, Hedström M, Modig K. The ASA score predicts infections, cardiovascular complications, and hospital readmissions after hip fracture - A nationwide cohort study. Osteoporos Int. 2021 Nov;32(11):2185-2192.
Doherty WJ, Stubbs TA, Chaplin A, Reed MR, Sayer AA, Witham MD, Sorial AK. Prediction of postoperative outcomes following hip fracture surgery: independent validation and recalibration of the Nottingham Hip Fracture Score. J Am Med Dir Assoc. 2020;22:663–669.e2.
Tsai CH, Lin CL, Hsu HC, Chung WS. Increased risk of stroke among hip fracture patients: a nationwide cohort study. Osteoporos Int. 2015;26(2):645–652.
Ansari S, Hassan M, Barry HD, Bhatti TA, Hussain SZM, Jabeen S, Fareed S. Risk Factors Associated with Surgical Site Infections: A Retrospective Report from a Developing Country. Cureus. 2019 Jun 2;11(6):e4801
Söderqvist A, Ekström W, Ponzer S, Pettersson H, Cederholm T, Dalén N, Hedström M, Tidermark J. Prediction of mortality in elderly patients with hip fractures: a two-year prospective study of 1,944 patients. Gerontology. 2009;55(5):496–504.
Ali AM, Gibbons CER. Predictors of 30-day hospital readmission after hip fracture: a systematic review. Injury. 2017;48(2):243–252.
Liu Y, Peng M, Lin L, Liu X, Qin Y, Hou X. Relationship between American Society of Anesthesiologists (ASA) grade and 1-year mortality in nonagenarians undergoing hip fracture surgery. Osteopor Internat. 2015 Mar; 26:1029-33.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Proceedings
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a 