A new classification for assessing the physical status of a patient by the American Society of Anesthesiologists (80 years of evolution)

Levin, Ya.I.; Корячкин, В А

doi:10.17116/anaesthesiology2021061107

Cited by 3 publications

(1 citation statement)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Все 376 пациентов выписаны из стационара. Степень тяжести сопутствующей патологии определяли по классификации анестезиологического риска Американского общества анестезиологов (American Society of Anesthesiologists -ASA) [8]. Констатация класса физического статуса по ASA расценивалась как интегральный показатель коморбидности.…”

Section: материалы и методыunclassified

Quality of Life in Long-Term After Knee Arthroplasty

Ткаченко¹,

Мансуров²,

Спичко³

et al. 2023

Хирургия. Восточная Европа

View full text Add to dashboard Cite

Введение. Проанализирована динамика качества жизни (КЖ) пациентов с остеоартритом, перенесших эндопротезирование коленного сустава (ЭКС), в течение 5 лет после операции. Оценивались общие результаты, а также КЖ в зависимости от половой принадлежности и от наличия коморбидности. Цель. Изучить отдаленные результаты тотальной артропластики тазобедренного и коленного суставов у пациентов с остеоартритом. Определить качество жизни пациента в зависимости от половой принадлежности и от наличия выраженной сопутствующей патологии. Материалы и методы. В исследование включено 376 пациентов с остеоартритом коленного сустава, перенесших первичное тотальное ЭКС в 2016–2019 гг. Возраст пациентов составил от 43 до 85 лет (65,4±5,5). Для оценки отдаленных результатов лечения применялся статистический метод анализа выживаемости, который дает возможность учитывать утраченные (цензурированные) случаи. Такой способ статистического анализа позволяет учитывать как случаи утраты связи с пациентом, так и пациентов с незавершенными сроками наблюдения. Результаты. На конец 5-го года наблюдения результатов ЭКС вероятность отличных и хороших результатов качества жизни составила 0,77 (0,72; 0,81). При анализе результатов выявлено, что показатели КЖ у женщин (0,79) достоверно лучше, чем у мужчин (0,67), на что указывает логранговый тест (Z=2,0347; p-value = 0,0445). Вероятность отличного и хорошего КЖ на 5-м году наблюдения при ASA I составила 0,76 (0,65; 0,87); при ASA II – 0,82 (0,75; 0,87); при ASA III – 0,72 (0,63; 0,80). Показатели у пациентов с ASA IV были хуже – 0,25 (0,12; 0,65). Статистически значимые различия кривых выживаемости между группами присутствовали только у пациентов с ASA IV. Логранговый тест – χ2 = 0,93551, уровень значимости p-value = 0,0283. Выводы: 1. Через 5 лет после ЭКС ожидать отличного и хорошего качества жизни можно у 77% пациентов, удовлетворительного и неудовлетворительного – у 23% пациентов. 2. КЖ у пациентов мужского пола статистически достоверно ниже, чем у женщин (отличное и хорошее КЖ через 5 лет после ЭКС верифицировано у 67% и 79% соответственно; p<0,05). 3. Достоверные отличия КЖ после ЭКС, с учетом коморбидности, имеются только при анализе результатов у пациентов с тяжелой сопутствующей патологией ASA IV (p<0,05), однако общая численность контингента таких пациентов составляет около 1%. Introduction. The quality of life (QoL) was analyzed in patients with osteoarthritis in 5 years after total knee arthroplasty (TKA). Overall results were assessed, as well as QoL depending on gender and comorbidity. Purpose. To determine the long-term results of total knee arthroplasty in patients with osteoarthritis and the patient’s QoL depending on gender and on the presence of severe comorbidity. Materials and methods. Total 376 patients with knee osteoarthritis after primary TKA in 2016–2019 were analyzed in the study. The average age of patients was 65.4±5.5 years. To assess the long-term outcomes the statistical method of survival analysis was used. This method makes it possible include into statistical analysis a censored cases, both cases of loss of communication with the patient and patients with incomplete follow-up. Results. The probability of excellent and good QoL after TKA was 0.77 (0.72; 0.81) after 5-year follow-up. The QoL in woman (0.79) are better than in men (0.67) as indicated by the log-rank test (Z=2.0347; p-value = 0.0445). The probability of excellent and good QoL in 5th year of follow-up with ASA I was 0.76 (0.65; 0.87); with ASA II – 0.82 (0.75; 0.87); according to ASA III – 0.72 (0.63; 0.80). The worst results were in patients with ASA IV 0.25 (0.12; 0.65). Statistically significant differences in survival curves between groups were only in patients with ASA IV, as indicated by the log-rank test (χ2=0.93551, p-value = 0.0283). Conclusions: 1. In 5 years after TKA, the excellent and good QoL have only 77% of patients, satisfactory and unsatisfactory – 23% of patients. 2. The QoL in male patients is lower than in women (in 5 years after TKA excellent and good QoL was verified in 67% and 79%, respectively; p<0.05). 3. Significant differences in the QoL after TKA are available only in patients with severe comorbidities ASA IV (p<0.05), however, the total number of these patients is about 1%.

show abstract

Section: материалы и методыunclassified

Quality of Life in Long-Term After Knee Arthroplasty

Ткаченко¹,

Мансуров²,

Спичко³

et al. 2023

Хирургия. Восточная Европа

View full text Add to dashboard Cite

show abstract

Проблемы Ранней Диагностики И Коррекции Белково-Энергетической Недостаточности У Пациентов Высокого Операционно-Анестезиологического Риска В Абдоминальной Онкохирургии: Обзор Литературы

Лейдерман,

Медведев,

Еремеева

et al. 2024

Annals of Critical Care

View full text Add to dashboard Cite

INTRODUCTION: The share of patients with high surgical and anesthesia risk in the total structure of oncological patients is increasing every year. Patients with protein-energy malnutrition (PEM) are characterized by a high frequency of postoperative complications. Progression of PEM in patients with high surgical and anesthesia risk occurs faster due to both the oncologic process itself and severe comorbidity. OBJECTIVE: To summarize and analyze information on modern methods of early diagnosis and correction of PEM in abdominal oncosurgery patients at high operative and anesthetic risk in the perioperative period. MATERIALS AND METHODS: A systematic search and selection of publications was performed using the bibliographic databases PubMed and eLibrary. Studies published in the last 15 years (2008–2023) were analyzed to investigate the problem. Relevant studies were limited to systematic literature reviews, meta-analyses, randomized controlled trials, prospective observational studies, retrospective studies. RESULTS: The use of special assessment systems that identify different stages of PEM (CASC IN, miniCASCO, new cachexia staging scale 2018) in cancer patients at high surgical and anesthetic risk creates conditions for the implementation of a personalized approach to the selection of nutritional support program in the perioperative period. Assessment of nutritional status, including the analysis of laboratory markers of malnutrition (total protein, albumin, serum transferrin), as well as qualitative assessment of body composition using bioimpedance analysis contribute to the early detection of PEM and allow for maximum personalization of nutritional support and hydration of this patients. CONCLUSIONS: This narrative review has shown that currently it is rather difficult to formulate algorithms for diagnostics and correction of PEM in patients with high surgical and anesthesia risk in abdominal oncosurgery. Research is required to determine the effectiveness of different scales of PEM staging. A personalized approach to early diagnosis and correction of PEM is one of the most promising strategies to reduce the incidence of postoperative complications in this category of patients.

show abstract

Prognostic significance of predictors of early postoperative cognitive disorders in patients after traumatic surgeries (prospective cohort study)

Ermokhina,

Kuzovlev,

Davydov

et al. 2024

Vestn. anesteziol. reanimatol.

View full text Add to dashboard Cite

The objective was to determine the prognostic value of predictors of early postoperative cognitive disorders in traumatological patients to assess the development of the main clinical outcomes (postoperative delirium and delayed neurocognitive recovery).Materials and methods. A two-center prospective cohort observational study of patients aged 45–74 years after planned traumatological operations (endoprosthetics of large joints of the lower extremities, spinal fusion surgery, transpedicular fixation of vertebrae) under general anesthesia with tracheal intubation was conducted in the period from March 2021 to June 2022. Before the operation, demographic indicators, concomitant diseases, background therapy, laboratory tests and testing (ASA, MoCA, AUDIT, CFS, HADS-A, RASS). At the end of the operation after extubation and in the postoperative period, patients were analyzed according to the scales RUS, CAM- ICU and CAM-ICU-7, NRS and BPS. Statistical analysis was carried out using the software SPSS Statistics 27.0.1.0.Results. The study included 200 patients. Early postoperative cognitive disorders (ePCD) (agitation and emergence delirium (ED)) 61 (30.5%) patients were diagnosed, 139 (69.5%) patients had adequate awakening in the operating room. Independent predictors of the development of ePCD were the age of patients (≥ 60), glucose level ≥ 5.6 and a high score on the Clinical Frailty Scale (≥ 4). The prevalence of postoperative delirium (POD) was 11% (22 patients). The independent risk factors for POD were the duration of hypotension and the presence of hyperactive ED. Delayed neurocognitive recovery after surgery and anesthesia was observed in 115 patients (57.8%). At the same time, a statistically significant predictor of this condition was the duration of hypotension for more than 15 minutes (sensitivity 59.18%, specificity 65.85%).Conclusion. When comparing the influence of the study group (patients with ePCD) with the control group, it was determined that ePCD is an independent risk factor for the development of POD (p < 0.001).

show abstract

A new classification for assessing the physical status of a patient by the American Society of Anesthesiologists (80 years of evolution)

Cited by 3 publications

References 5 publications

Quality of Life in Long-Term After Knee Arthroplasty

Quality of Life in Long-Term After Knee Arthroplasty

Prognostic significance of predictors of early postoperative cognitive disorders in patients after traumatic surgeries (prospective cohort study)

Contact Info

Product

Resources

About