Review of the ASA Physical Status Classification: Comment

Abouleish, Amr E.; Gal, Jonathan S.; Troianos, Christopher A.; Merrick, Sharon K.; Cohen, Neal; Stead, Stanley W.

doi:10.1097/aln.0000000000004145

Cited by 27 publications

(33 citation statements)

References 4 publications

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“…The median hospital length of stay was 15 ( 10 – 28 ) days. Fourtyseven (77%) patients were admitted to the ICU with a median duration of ICU stay of 8 ( 3 – 14 ) days. Mechanical ventilation was necessary in 38 patients (62%) with a median duration of 6.5 days.…”

Section: Resultsmentioning

confidence: 99%

“…Patient characteristics measured at hospital admission included age, sex, body mass index (BMI), American Society of Anaesthesiologist (ASA) score, presence of chronic obstructive pulmonary disease (COPD), smoking status, trauma mechanism, abbreviated injury scale (AIS) score ( 13 ), injury severity score (ISS), number of fractured ribs, concomitant injuries (i.e., pulmonary contusion, pneumothorax, haemothorax, sternum, and/or clavicle fracture), and laboratory results (specifically venous blood pH and base excess) ( 14 , 15 ).…”

Section: Methodsmentioning

confidence: 99%

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Quality of life and clinical outcomes of operatively treated patients with flail chest injuries: A multicentre prospective cohort study

Hoepelman

Minervini²,

Beeres³

et al. 2023

Front. Surg.

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IntroductionMost studies about rib fractures focus on mortality and morbidity. Literature is scarce on long term and quality of life (QoL) outcomes. Therefore, we report QoL and long-term outcomes after rib fixation in flail chest patients.MethodsA prospective cohort study of clinical flail chest patients admitted to six level 1 trauma centres in the Netherlands and Switzerland between January 2018 and March 2021. Outcomes included in-hospital outcomes and long-term outcomes, such as QoL measurements 12 months after hospitalization using the EuroQoL five dimensions (EQ-5D) questionnaire.ResultsSixty-one operatively treated flail chest patients were included. Median hospital length of stay was 15 days and intensive care length of stay was 8 days. Sixteen (26%) patients developed pneumonia and two (3%) died. One year after hospitalization the mean EQ5D score was 0.78. Complication rates were low and included hemothorax (6%) pleural effusion (5%) and two revisions of the implant (3%). Implant related irritation was commonly reported by patients (n = 15, 25%).ConclusionsRib fixation for flail chest injuries can be considered a safe procedure and with low mortality rates. Future studies should focus on quality of life rather than solely short-term outcomes.Trial registration: Registered in the Netherlands Trial Register NTR6833 on 13/11/2017 and the Swiss Ethics Committees Registration Number 2019-00668

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Quality of life and clinical outcomes of operatively treated patients with flail chest injuries: A multicentre prospective cohort study

Hoepelman

Minervini²,

Beeres³

et al. 2023

Front. Surg.

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“…The following variables were chosen for inclusion in multivariable analysis: body mass index (BMI), 25 a derived continuous variable defined as weight/height 2 (kg/m 2 ); age, a categorical variable of increasing 6-month increments; duration of operation, a binary variable defined as greater or less than the median value of 143 minutes; steroid use within 30 days, a binary variable (yes/no); bilateral vs unilateral implantation, a binary variable; hospital length of stay (LOS), a continuous variable measured in days; and American Society of Anesthesiologists (ASA) class, a categorical variable defined as no disturbance, mild disturbance, or severe/life-threatening disturbance. 26 Steroid use within 30 days is defined by the ACS-NSQIP Pediatric database as follows: ''Patient has required the administration of oral or parenteral corticosteroid medication in the 30 days prior to surgery and includes patients who receive short course oral or IV steroids. Corticosteroids applied topically or administered rectally or by inhalation are not included.''…”

Section: Methodsmentioning

confidence: 99%

Predictors of Surgical Site Infection in Pediatric Cochlear Implantation

Quimby

Grose

Reddy

et al. 2022

Otolaryngol.--head neck surg.

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Objective To determine risk factors for surgical site infection (SSI) after cochlear implantation (CI) in pediatric patients. Study Design Case-control study. Setting A total of 150 hospitals contributing data to the ACS-NSQIP Pediatric database (American College of Surgeons National Surgical Quality Improvement Program) in North America and worldwide. Methods Pediatric patients (aged <18 years) undergoing CI during the years 2012 to 2017 were identified in the ACS-NSQIP Pediatric database. Uni- and multivariable logistic regression analyses were used to determine the odds ratios (ORs) of SSI (including superficial incisional, deep incisional, organ/space) occurring up to 30 days postoperatively. Results A total of 79 SSIs occurred over a 5-year period (n = 5146). Longer operative time significantly increased the odds of SSI (OR, 1.965; 95% CI, 1.205-3.289). Younger age was also found to raise the odds of SSI, with decreased odds associated with each 6-month increase in age (OR, 0.887; 95% CI, 0.814-0.958). Conclusion Longer operative time and younger age appear to significantly increase the odds of SSI in pediatric CI. Body mass index, recent steroid use, American Society of Anesthesiologists class, bilateral vs unilateral implantation, and hospital length of stay do not appear to significantly influence SSI risk. These findings must be interpreted in the context of the limitations inherent to adverse events reporting, which are mitigated by the stringent manner of data collection by the ACS-NSQIP, and those inherent to the definition of SSI. Future prospective studies should investigate the impact of reducing operative time on the risk of SSI and other complications in pediatric CI.

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“…Edad entre 18 y 40 años (incluidos los extremos), embarazo a término con feto vivo y sano, y programación para cesárea, primigestas o multigestas, valoración preoperatoria ASA I o ASA II 13 , medicación preanestésica adecuada e igualitaria, técnica anestésica transoperatoria consistente en bloqueo epidural sin uso de opioides, pacientes que firmaron el consentimiento informado autorizando participar en el estudio.…”

Section: Criterios De Inclusiónunclassified

Eficacia y seguridad de una combinación de clonixinato de lisina y ketorolaco en el tratamiento del dolor postoperatorio en cesárea

Ramírez-Palacios¹,

Pérez-Gómez²,

Barbieri-Sarubbi³

2023

RHJM

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Antecedentes. El alivio del dolor en el postoperatorio de cesárea es sumamente importante para el bienestar materno y neonatal, por lo que es fundamental encontrar el mejor analgésico que sea eficaz y seguro. Objetivo. Evaluar la eficacia y seguridad de un nuevo preparado que contiene clonixinato de lisina 125 mg + ketorolaco 5 mg (CLK) administrado intravenosamente, comparando con ketorolaco (K) 30 mg intravenoso después de una operación cesárea. Conservar el mismo o un mayor nivel de analgesia al sustituir parte de ketorolaco por clonixinato de lisina, el cual es un analgésico con menos efectos adversos que el K. Material y métodos. Se estudiaron 170 mujeres durante el postoperatorio de cesárea clasificadas aleatoriamente en dos grupos: 85 recibieron CLK y 85 recibieron K intravenosamente. La intensidad del dolor se registró cada 4 horas durante 24-h empleando la escala visual análoga (EVA) y la escala de evaluación verbal. Cada tratamiento se administró con valores de EVA ≥ 4 o por demanda de la paciente. Se registraron el uso de analgesia de rescate y el número de eventos adversos. Resultados. Las pacientes que recibieron CLK mostraron una mejor analgesia que aquellas que recibieron K, no se presentaron eventos adversos ni se encontraron anormalidades en el examen físico ni en el tiempo de sangrado. Conclusiones. El tratamiento del dolor postoperatorio en cesárea mostró que CLK fue más efectivo que K en todas las variables de eficacia. Ambos tratamientos fueron igualmente seguros.

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Review of the ASA Physical Status Classification: Comment

Cited by 27 publications

References 4 publications

Quality of life and clinical outcomes of operatively treated patients with flail chest injuries: A multicentre prospective cohort study

Quality of life and clinical outcomes of operatively treated patients with flail chest injuries: A multicentre prospective cohort study

Predictors of Surgical Site Infection in Pediatric Cochlear Implantation

Eficacia y seguridad de una combinación de clonixinato de lisina y ketorolaco en el tratamiento del dolor postoperatorio en cesárea

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