Hauber Elke, Alef Michaele
Klinik für Kleintiere, Abteilung für Anästhesiologie und Intensivmedizin, Veterinärmedizinische Fakultät der Universität Leipzig.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2022 Aug;50(4):249-260. doi: 10.1055/a-1839-5859. Epub 2022 Jun 14.
The Leipzig Veterinary Risk-Index - "LeiV-Risk-Index" is a multifactorial risk index developed to enable an improved objective assessment of the anesthetic risk in dogs. The scoring system is based on 10 risk factors affecting perioperative mortality. The aim of this study was to evaluate the applicability of the LeiV-Risk-Index and its risk factors as well as to perform a direct comparison with the ASA-classification.
An online survey was conducted among veterinarians working in small animal medicine throughout Germany. Participants received a questionnaire containing information on 15 selected patients. They were asked to classify the patients according to the LeiV-Risk-Index and ASA-classification and to answer several questions concerning their professional background. The results were statistically analyzed considering the consistency among veterinarians of rating the different patients by using Fleiss'-Kappa. The correlation of LeiV-Risk-Index and ASA-classification was calculated.
The consistency of all assigned LeiV-risk classes between participants was moderate (κ = 0.55) and higher than classification by ASA (κ = 0.33). On average, 3 different LeiV-risk classes and 4 different ASA-classes were assigned for one patient. There was a positive correlation between LeiV-risk class and increasing ASA-class. No effect of gender or clinical experience of the veterinarian could be demonstrated on ranking patients. There was also no effect of how confident veterinarians felt in applying the LeiV-Risk-Index.
The LeiV-Risk-Index is the first index available in veterinary medicine for assessing anesthetic risk that is based on objective risk criteria and whose objectivity exceeds that of the ASA classification. Anesthetic patients can thus be evaluated more consistently in veterinary medicine as well. Utility and practicability were positively received by 95 % of the participants. Further revision of individual risk criteria needs to be reconsidered.
