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麻醉实践中美国麻醉医师协会身体状况量表可靠性分析:一项观察性研究。

Analysis of the American Society of Anesthesiologists Physical Status Scale Reliability in Anaesthesia Practice: An Observational Study.

作者信息

Shah Prerana, Saran Anita, Das Suvankar

机构信息

King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India.

出版信息

Turk J Anaesthesiol Reanim. 2020 Oct;48(5):385-390. doi: 10.5152/TJAR.2019.50146. Epub 2019 Oct 17.

Abstract

OBJECTIVE

Anaesthesiologists use the American Society of Anesthesiologists physical status (ASA PS) classification to assess patients' overall health. The primary objective of this study was to predict the prognostic value regarding peri-operative variables until discharge from hospital and post-operative outcomes. The secondary objective was to evaluate the inter-rater agreement of the ASA scores assigned at the outpatient department (OPD) vs. operating theatres (OT).

METHODS

A total of 227 adults scheduled for elective surgery were assigned the ASA grade in preoperative OPD and on the day of surgery. The type of anaesthesia and surgery were noted. The operating time, post-operative ventilation, intensive care unit (ICU) stay, post-operative stay, bronchopulmonary complications, cardiac complications, renal dysfunction and any mortality until discharge from hospital were noted. Descriptive statistics were used to report the primary objective. For the secondary objective, Pearson's correlation test was used for inter-rater reliability.

RESULTS

The ASA grading done at OPD and at OT was the same. It was found that the higher the ASA grade of a patient, the longer was the ICU stay. Patients with higher ASA PS scores were at a comparatively milder risk of developing remaining peri-operative and post-operative complications.

CONCLUSION

The correlation was the highest with the ICU stay. The inter-rater ASA grades assignment at the clinics and the OT were found to be almost perfect.

摘要

目的

麻醉医生使用美国麻醉医师协会身体状况(ASA PS)分类来评估患者的整体健康状况。本研究的主要目的是预测直至出院的围手术期变量及术后结果的预后价值。次要目的是评估门诊(OPD)与手术室(OT)所分配的ASA评分的评分者间一致性。

方法

共有227名计划进行择期手术的成年人在术前门诊和手术当天被评定ASA分级。记录麻醉和手术类型。记录手术时间、术后通气、重症监护病房(ICU)住院时间、术后住院时间、支气管肺部并发症、心脏并发症、肾功能障碍以及直至出院的任何死亡率。使用描述性统计来报告主要目的。对于次要目的,使用Pearson相关检验来评估评分者间的可靠性。

结果

门诊和手术室的ASA分级相同。发现患者的ASA分级越高,ICU住院时间越长。ASA PS评分较高的患者发生其余围手术期和术后并发症的风险相对较低。

结论

与ICU住院时间的相关性最高。发现在诊所和手术室的评分者间ASA分级几乎完全一致。

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