RETROSPECTIVE EVALUATION OF ASA CLASSIFICATION’S PREDICTIVE ABILITY OF POSTOPERATIVE COMPLICATIONS IN PATIENTS ADMITTED TO INTENSIVE CARE UNIT AFTER MAJOR ABDOMINOPELVIC SURGERY

Emre Sertaç Bingül; Ayşe Hızal; Başar Erdivanlı; Hizir Kazdal

Makale detayları

RETROSPECTIVE EVALUATION OF ASA CLASSIFICATION’S PREDICTIVE ABILITY OF POSTOPERATIVE COMPLICATIONS IN PATIENTS ADMITTED TO INTENSIVE CARE UNIT AFTER MAJOR ABDOMINOPELVIC SURGERY

Yazarlar:

Emre Sertaç Bingül | Ayşe Hızal | Başar Erdivanlı | Hizir Kazdal

Yayıncı:

Istanbul University

Ana Başlıklar:

Anaesthesiology

Dergi:

Journal of Advanced Research in Health Sciences Vol.7 Issue 3, pp.143-149

Belge Tipi:

Makale

Yayın Tarihi:

10/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001340862

pISSN:

2651-4060

Anahtar kelimeler:

Özet:

 Objective: The American Society of Anaesthesiologists Physical Status Score ASA is a useful tool for indicating the need for intensive care unit ICU monitoring in postoperative patients. However, physician misclassification can lead to unnecessary bed occupancy and increased costs. This study examined the relationship between preoperative ASA scores and complications following major abdominopelvic surgery. Materials and Methods: Patients who underwent postoperative monitoring in a tertiary ICU between November 2016 and February 2019 for semi-urgent and urgent major abdominopelvic surgery were evaluated. Data related to morbidity and mortality were analysed, including acute postoperative complications hypotension, bleeding, desaturation, prolonged intubation, failed weaning, acute kidney injury, cardiac arrest, exitus, length of ICU stay, recurrent ICU admissions, overall mortality incidence, and 30-day mortality incidence. Results: A total of 122 patients who underwent gastrointestinal, gynaecological, and urological surgeries were retrospectively analysed. Patients were grouped as ASA II N59, ASA III N45, and ASA IV n18. Overall complication rates among the groups did not differ. The exitus rate was significantly higher in ASA IV p0.022. Similarly, the duration of ICU stay, recurrent ICU admissions, and 30-day mortality were significantly higher in ASA IV p0.05. When patients were grouped as semi-urgent n87 and urgent n35, respiratory complications such as prolonged intubation, desaturation, and failed weaning, as well as ICU stay and 30-day mortality rates were higher in urgent cases p0.001. No exitus was observed in the semi-urgent oncological surgeries in the ICU. Conclusion: No difference in respiratory complications was observed in the postoperative ICU follow-up of ASA IV major abdominal surgery patients compared with other ASA groups. However, both respiratory complications and mortality rates were significantly higher in the urgent cases. The low rate of complications in semi-urgent oncological surgeries can be explained by the optimal preoperative surgical preparation.

 Objective: The American Society of Anaesthesiologists Physical Status Score ASA is a useful tool for indicating the need for intensive care unit ICU monitoring in postoperative patients. However, physician misclassification can lead to unnecessary bed occupancy and increased costs. This study examined the relationship between preoperative ASA scores and complications following major abdominopelvic surgery. Materials and Methods: Patients who underwent postoperative monitoring in a tertiary ICU between November 2016 and February 2019 for semi-urgent and urgent major abdominopelvic surgery were evaluated. Data related to morbidity and mortality were analysed, including acute postoperative complications hypotension, bleeding, desaturation, prolonged intubation, failed weaning, acute kidney injury, cardiac arrest, exitus, length of ICU stay, recurrent ICU admissions, overall mortality incidence, and 30-day mortality incidence. Results: A total of 122 patients who underwent gastrointestinal, gynaecological, and urological surgeries were retrospectively analysed. Patients were grouped as ASA II N59, ASA III N45, and ASA IV n18. Overall complication rates among the groups did not differ. The exitus rate was significantly higher in ASA IV p0.022. Similarly, the duration of ICU stay, recurrent ICU admissions, and 30-day mortality were significantly higher in ASA IV p0.05. When patients were grouped as semi-urgent n87 and urgent n35, respiratory complications such as prolonged intubation, desaturation, and failed weaning, as well as ICU stay and 30-day mortality rates were higher in urgent cases p0.001. No exitus was observed in the semi-urgent oncological surgeries in the ICU. Conclusion: No difference in respiratory complications was observed in the postoperative ICU follow-up of ASA IV major abdominal surgery patients compared with other ASA groups. However, both respiratory complications and mortality rates were significantly higher in the urgent cases. The low rate of complications in semi-urgent oncological surgeries can be explained by the optimal preoperative surgical preparation.

 Objective: The American Society of Anaesthesiologists Physical Status Score ASA is a useful tool for indicating the need for intensive care unit ICU monitoring in postoperative patients. However, physician misclassification can lead to unnecessary bed occupancy and increased costs. This study examined the relationship between preoperative ASA scores and complications following major abdominopelvic surgery. Materials and Methods: Patients who underwent postoperative monitoring in a tertiary ICU between November 2016 and February 2019 for semi-urgent and urgent major abdominopelvic surgery were evaluated. Data related to morbidity and mortality were analysed, including acute postoperative complications hypotension, bleeding, desaturation, prolonged intubation, failed weaning, acute kidney injury, cardiac arrest, exitus, length of ICU stay, recurrent ICU admissions, overall mortality incidence, and 30-day mortality incidence. Results: A total of 122 patients who underwent gastrointestinal, gynaecological, and urological surgeries were retrospectively analysed. Patients were grouped as ASA II N59, ASA III N45, and ASA IV n18. Overall complication rates among the groups did not differ. The exitus rate was significantly higher in ASA IV p0.022. Similarly, the duration of ICU stay, recurrent ICU admissions, and 30-day mortality were significantly higher in ASA IV p0.05. When patients were grouped as semi-urgent n87 and urgent n35, respiratory complications such as prolonged intubation, desaturation, and failed weaning, as well as ICU stay and 30-day mortality rates were higher in urgent cases p0.001. No exitus was observed in the semi-urgent oncological surgeries in the ICU. Conclusion: No difference in respiratory complications was observed in the postoperative ICU follow-up of ASA IV major abdominal surgery patients compared with other ASA groups. However, both respiratory complications and mortality rates were significantly higher in the urgent cases. The low rate of complications in semi-urgent oncological surgeries can be explained by the optimal preoperative surgical preparation.

 Amaç: Amerikan Anesteziyoloji Derneği Fiziksel Durum Skoru ASA postoperatif hastalarda yoğun bakım ünitesi YBÜ takibi endikasyonu koymada yararlı bir araçtır. Öte yandan hekimlerin yanlış skorlamaları yatakların gereksiz meşguliyetine ve artan hastane masraflarına yol açabilir. Bu çalışmada major abdominopelvik cerrahi sonrası komplikasyonların preoperatif ASA skorları ile ilişkisi incelendi. Gereç ve Yöntem: Kasım 2016 ve Şubat 2019 tarihleri arasında üçüncü düzey YBÜde postoperatif takibi gerçekleştirilen semi-acil ve acil major abdominopelvik cerrahi hastaları değerlendirildi. Morbidite ve mortalite ile ilişkili veriler; akut postoperatif komplikasyonlar hipotansiyon, kanama, desaturasyon, uzamış entübasyon, başarısız weaning, akut böbrek hasarı, kardiyak arrest, eksitus, YBÜ takip süresi, tekrarlayan YBÜ yatışları, genel mortalite insidansı ve 30-gün mortalite insidansı şeklinde analiz edildi. Bulgular: 122 gastrointestinal, jinekolojik ve ürolojik cerrahi hastası retrospektif olarak analiz edildi. Hastalar; ASA II n59, ASA III N45 ve ASA IV n18 olarak gruplandırıldı. Genel komplikasyon oranlarında gruplar arasında anlamlı farklılık yoktu. Eksitus oranı ASA IV grubunda anlamlı yüksekti p0,022. Aynı şekilde YBÜ yatış süresi, YBÜne tekrarlayan yatış ve 30-gün mortalite yine ASA IV grubunda anlamlı yüksekti p0,05. Hasta gruplandırması semi-acil n87 ve acil n35 olarak yapıldığında uzamış entübasyon, desaturasyon ve başarısız weaning gibi solunumsal komplikasyonlar, ayrıca YBÜ yatış süresi ve 30-gün mortalite oranı acil vakalarda daha fazlaydı p0,001. Yarı-acil onkolojik cerrahilerde YBÜde eksitus gözlenmedi. Sonuç: ASA IV major abdominopelvik cerrahi hastalarının postoperatif YBÜ takibinde solunumsal komplikasyonlar açısından diğer gruplar ile fark gözlenmedi. Buna karşın acil vakalarda hem solunumsal komplikasyon hem de mortalite oranları anlamlı yüksekti. Yarı-acil onkolojik cerrahilerde komplikasyonların az olması preoperatif optimum cerrahi hazırlık sağlanması ile açıklanabilir.

Makale detayları

RETROSPECTIVE EVALUATION OF ASA CLASSIFICATION’S PREDICTIVE ABILITY OF POSTOPERATIVE COMPLICATIONS IN PATIENTS ADMITTED TO INTENSIVE CARE UNIT AFTER MAJOR ABDOMINOPELVIC SURGERY

Yazarlar:

Emre Sertaç Bingül | Ayşe Hızal | Başar Erdivanlı | Hizir Kazdal

Yayıncı:

Istanbul University

Ana Başlıklar:

Anaesthesiology

Dergi:

Journal of Advanced Research in Health Sciences Vol.7 Issue 3, pp.143-149

Belge Tipi:

Makale

Yayın Tarihi:

10/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001340862

pISSN:

2651-4060

Intensive care

major abdominal surgery

major pelvic surgery

oncologic surgery

postoperative complications

mortalityYoğun bakım

major abdominal cerrahi

major pelvik cerrahi

onkolojik cerrahi

postoperatif komplikasyonlar

mortalite

Sayı

Makale detayları

Yazarlar: Emre Sertaç Bingül | Ayşe Hızal | Başar Erdivanlı | Hizir Kazdal

Yayıncı: Istanbul University

Ana Başlıklar: Anaesthesiology

Dergi: Journal of Advanced Research in Health Sciences Vol.7 Issue 3, pp.143-149

Belge Tipi: Makale

Yayın Tarihi: 10/2024

Belge Dili: İngilizce

Document ID (Org No.): 2001340862

pISSN: 2651-4060

Sayı

Yazarlar:

Emre Sertaç Bingül | Ayşe Hızal | Başar Erdivanlı | Hizir Kazdal

Yayıncı:

Istanbul University

Ana Başlıklar:

Anaesthesiology

Dergi:

Journal of Advanced Research in Health Sciences Vol.7 Issue 3, pp.143-149

Belge Tipi:

Makale

Yayın Tarihi:

10/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001340862

pISSN:

2651-4060