Lorenz W, Dick W, Junginger T, Ohmann C, Doenicke A, Rothmund M
Institut für Theoretische Chirurgie, Philipps-Universität, Marburg.
Langenbecks Arch Chir. 1987;372:199-209. doi: 10.1007/BF01297815.
Perioperative risk research with biomedical (biochemical, physiological) methods must grow up as a main topic in surgical research. However, operative risk has also to be analysed with methods of clinimetrics, such as formal (objective) decision making and epidemiology. Only by this way a convincing practical dimension is added to basic scientific statements. ASA-classification of the preoperative physical status is a global index for estimating the operative risk. It contains objective findings, subjective impressions and the final clinical judgement. For this reason it is so flexible. For a multicentre trial on perioperative risk and histamine an empirical index was constructed using both the ASA-classification and the Mannheim-Munich risk check list.
运用生物医学（生物化学、生理学）方法进行围手术期风险研究必须成为外科研究的一个主要课题。然而，手术风险也必须采用临床计量学方法进行分析，如形式化（客观）决策和流行病学方法。只有这样，才能在基础科学论断中增添令人信服的实践维度。术前身体状况的美国麻醉医师协会（ASA）分级是评估手术风险的一个综合指标。它包含客观检查结果、主观印象以及最终的临床判断。正因如此，它具有很强的灵活性。在一项关于围手术期风险和组胺的多中心试验中，同时使用ASA分级和曼海姆 - 慕尼黑风险检查表构建了一个经验性指标。
