TY - JOUR
T1 - Evaluation of the American Society of Anesthesiologists physical status classification system in risk assessment for plastic and reconstructive surgery patients
AU - Miller, Travis J.
AU - Jeong, Haneol S.
AU - Davis, Kathryn
AU - Matthew, Anoop
AU - Lysikowski, Jerzy
AU - Cho, Min Jeong
AU - Reed, Gary
AU - Kenkel, Jeffrey M.
PY - 2014/3
Y1 - 2014/3
N2 - Background: The American Society of Anesthesiologists Physical Status (ASA-PS) classification is a ranking system that quantifies patient health before anesthesia and surgery. Some surgical disciplines apply the ASA-PS to gauge a patients likelihood of developing postoperative complications. Objective: In this study, the authors analyze whether ASA-PS scores can successfully predict risk for postoperative complications in plastic and reconstructive operations. Methods: The authors retrospectively reviewed the charts of 1801 patient procedures and selected for inclusion 1794 complex plastic and reconstructive operations that took place at 1 of several academic medical institutions between January 2008 and January 2012. ASA-PS scores, patient comorbidities, and postoperative complications were analyzed. Percentile data were treated with tests for proportions. Nonpercentile data were analyzed through comparison of means (t test). Low-risk (ASA 1-2) and high-risk (ASA 3+) groups were compared with simple odds ratios. Results: For the 1430 women and 364 men in the patient cohort (average age, 49.5 years), the overall complication rate was 27.7%. When patients with complications were compared to those without, body mass index, operation time, recent major surgery, diabetes, hypertension, renal disease, cancer, and oral contraceptive use were statistically significant. After high-risk (n = 398) and low-risk (n = 1396) groups were identified, infection, delayed wound healing, deep vein thrombosis, and overall complications had significantly increased incidence in the high risk group. Notably, deep vein thrombosis displayed the highest odds ratio (4.17) and a complication rate increase from 0.93% to 3.77%. Conclusions: ASA-PS scores can be used either as substitutes for or as adjuncts to questionnaire-based risk assessment methods in plastic surgery. In addition to deducing significant findings for deep vein thrombosis incidence, ASA-PS scores hold important predictive associations for multiple non venous thromboembolism complications, providing a broader measurement for postoperative complication risks.
AB - Background: The American Society of Anesthesiologists Physical Status (ASA-PS) classification is a ranking system that quantifies patient health before anesthesia and surgery. Some surgical disciplines apply the ASA-PS to gauge a patients likelihood of developing postoperative complications. Objective: In this study, the authors analyze whether ASA-PS scores can successfully predict risk for postoperative complications in plastic and reconstructive operations. Methods: The authors retrospectively reviewed the charts of 1801 patient procedures and selected for inclusion 1794 complex plastic and reconstructive operations that took place at 1 of several academic medical institutions between January 2008 and January 2012. ASA-PS scores, patient comorbidities, and postoperative complications were analyzed. Percentile data were treated with tests for proportions. Nonpercentile data were analyzed through comparison of means (t test). Low-risk (ASA 1-2) and high-risk (ASA 3+) groups were compared with simple odds ratios. Results: For the 1430 women and 364 men in the patient cohort (average age, 49.5 years), the overall complication rate was 27.7%. When patients with complications were compared to those without, body mass index, operation time, recent major surgery, diabetes, hypertension, renal disease, cancer, and oral contraceptive use were statistically significant. After high-risk (n = 398) and low-risk (n = 1396) groups were identified, infection, delayed wound healing, deep vein thrombosis, and overall complications had significantly increased incidence in the high risk group. Notably, deep vein thrombosis displayed the highest odds ratio (4.17) and a complication rate increase from 0.93% to 3.77%. Conclusions: ASA-PS scores can be used either as substitutes for or as adjuncts to questionnaire-based risk assessment methods in plastic surgery. In addition to deducing significant findings for deep vein thrombosis incidence, ASA-PS scores hold important predictive associations for multiple non venous thromboembolism complications, providing a broader measurement for postoperative complication risks.
KW - aesthetic surgery
KW - anesthesia
KW - complications
KW - physical status classification
KW - postoperative complications
KW - risk assessment
UR - http://www.scopus.com/inward/record.url?scp=84899433554&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899433554&partnerID=8YFLogxK
U2 - 10.1177/1090820X14525394
DO - 10.1177/1090820X14525394
M3 - Article
C2 - 24676415
AN - SCOPUS:84899433554
SN - 1090-820X
VL - 34
SP - 448
EP - 456
JO - Aesthetic surgery journal
JF - Aesthetic surgery journal
IS - 3
ER -