Can ASA grade or Goldman's cardiac risk index predict peri‐operative mortality? A study of 16 227 patients

Prause, Gerhard; Ratzenhofer-Comenda, B; Pierer, Gerhard; Smolle‐Jüttner, Freyja‐Maria; Glanzer, H.; Smolle, Josef

doi:10.1111/j.1365-2044.1997.074-az0074.x

Cited by 141 publications

(74 citation statements)

References 14 publications

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“…[21][22][23] Hamlet et al reported a relationship between preoperative health status and the time to postoperative mortality, and late functional outcome in hip fracture patients. 24 Preoperative health status was assessed by the ASA classification.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Different Anesthetic Techniques on Postoperative Outcomes in Elderly Patients with Hip Fracture

Şahin¹,

Heybeli²,

Çolak³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Determining the type of anesthesia is a complex medical decision that depends on many factors including co-morbidity, age, type of surgery performed, and the risk of the anesthetic techniques. This study evaluated the effects of anesthesia type on postoperative mortality and morbidity in hip fractures. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : One hundred eighty-five patients older than 60 years who were operated for hip fracture between 2005-2009 were retrospectively analyzed. Patients received general anesthesia (n=67), spinal anesthesia (n=67), or epidural anesthesia (n=51). The clinical features of the patients were obtained from the hospital records. Morbidity outcomes were assessed on postoperative day 7. Mortality rates were calculated on postoperative day 7 and postoperative day 30. R Re es su ul lt ts s: : There were no significant differences between the three groups with regard to intraoperative blood loss, intraoperative blood transfusion, smoking status, length of stay in hospital, American Society of Anesthesiology (ASA) physical status, and Charlson Comorbidity Index (CCI) (p=0.393, p=0.088, p=0.369, p=0.228, p=0.491, p=0.371 respectively). Similarly, no difference was detected between the three groups regarding patient mortality rates for day 7 and 30 (p=0.738, p=0.805 respectively). C Co on nc cl lu us si io on n: : No technique was superior to the others. Due to the similar mortality rates among the groups, we suggest that the proper anesthetic technique selected according to the clinical features of the patient combined with adequate monitorization would yield successful results with all three techniques. K Ke ey y W Wo or rd ds s: : Hip fractures; mortality; anesthesia Ö ÖZ ZE ET T A Am ma aç ç: : Anestezi tipinin belirlenmesi, yaş, uygulanacak cerrahi tipi ve anestezi tekniklerinin riski gibi birçok faktörün göz önüne alınmasını gerektiren, kompleks bir tıbbi karardır. Bu çal-ışmada, kalça kırıklarında anestezi tipinin cerrahi sonrası mortalite ve morbidite üzerindeki etkileri değerlendirilmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmada, 2005-2009 yılları arasında kalça kırığı operasyonu geçiren 60 yaş üzeri 185 hasta retrospektif olarak analiz edilmiştir. Hastalara genel anestezi (n=67), spinal anestezi (n=67) ve epidural anestezi (n=51) yöntemlerinden biri uygulanmıştır. Hastalara ait klinik bilgiler hastane kayıtlarından elde edilmiştir. Morbidite sonuç-ları operasyon sonrası yedinci günde değerlendirilmiştir. Mortalite oranı ise operasyon sonrası 7. ve 30. günlerde hesaplanmıştır. B Bu ul lg gu ul la ar r: : Her üç grupta cerrahi sırasındaki kan kaybı ve kan transfüzyonu, sigara içme durumu, hastanede kalış süresi, American Society of Anesthesiology (ASA) skoru ve Charlson morbidite indeksi skoru açısından anlamlı bir fark bulunmamıştır (sırasıyla p=0,393, p=0,088, p=0,369, p=0,228, p=0,491, p=0,371). Hastaların 7. ve 30. günlerdeki mortalite oranları açısından gruplar arasında anlamlı bir f...

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Section: Discussionmentioning

confidence: 99%

Comparison of Different Anesthetic Techniques on Postoperative Outcomes in Elderly Patients with Hip Fracture

Şahin¹,

Heybeli²,

Çolak³

et al. 2012

Turkiye Klinikleri J Med Sci

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“…Studies by Lee Goldman as author [6,16,[19][20][21][22][23][24][25] and coauthor [5,15,17,18,[26][27][28][29][30][31], as well as studies of other authors that used Goldman's CRI [7][8][9][10][11][12][13], found statistical significance of the incidence of all types of perioperative cardiac complications between the four stratification subgroups of patients undergoing noncardiac surgery. The same studies proved that all 9 Goldman's risk factors were independent predictors of poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, they established highly significant differences between four stratification groups in the incidence of perioperative minor, major and fatal cardiac complications [6]. Using Goldman's cardiac risk index in the following 30 years, many studies confirmed and validated its clinical significance, and therefore, the index is today widely used in perioperative medicine [7][8][9][10][11][12][13]. One study compared four scoring systems for risk evaluation in noncardiac surgery, among which Goldman's cardiac Table 4.…”

Section: Discussionmentioning

confidence: 99%

Risk assessment in coronary patients undergoing abdominal nonvascular surgery

Karapandzic¹,

Matić²,

Peško³

et al. 2009

Open Medicine

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AbstractThe aim of our study was to establish that the incidence of perioperative cardiac complications were in direct correlation with level of operative risk in coronary patients undergoing open abdominal nonvascular surgery with general anesthesia. Our prospective observational clinical study was composed of a group of 111 consecutive patients with angiographically-verified coronary artery disease, who were operated on at the University Clinical Center of Serbia. The patients were classified into four stratification subgroups by “Goldman’s Cardiac Risk Index” (CRI) in relation to the incidence of perioperative cardiac complications. Electrocardiography was performed immediately after surgery, on postoperative days 1, 2, 7 and one day before discharge from the hospital. All patients were followed to postoperative day 30. Statistical design was presented by Pearson’s χ2 test and binomial logistic regression. The main result was significant difference between the four stratification subgroups of coronary patients in the incidence of cardiac death up to the 30th postoperative day: I — 0/17 (0.0%) vs. II — 0/40 (0.0%) vs. III — 1/37 (2.7%) vs. IV — 2/17 (11.8%), (p<0.05). We concluded that the incidence of perioperative cardiac complications significantly increased with the degree of Goldman’s CRI. There was significant difference in the incidence of perioperative cardiac complications between the four Goldman’s stratification subgroups.

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“…Even simple subjective measures such as the ASA (American Society of Anesthesiologists) score stratify patients by surgical risk [10]. A combination of risk factors such as age, co-morbidity, presenting pathology, proposed surgery and physiological measurements have been used in several studies [11][12][13].…”

mentioning

confidence: 99%

Are we operating as well as we can? Critical care to minimise postoperative mortality and morbidity

Goldhill¹,

Down²

2008

Anaesthesia

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Can ASA grade or Goldman's cardiac risk index predict peri‐operative mortality? A study of 16 227 patients

Cited by 141 publications

References 14 publications

Comparison of Different Anesthetic Techniques on Postoperative Outcomes in Elderly Patients with Hip Fracture

Comparison of Different Anesthetic Techniques on Postoperative Outcomes in Elderly Patients with Hip Fracture

Risk assessment in coronary patients undergoing abdominal nonvascular surgery

Are we operating as well as we can? Critical care to minimise postoperative mortality and morbidity

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