Adeyemi Oluwaseun John, Meltzer-Bruhn Ariana, Esper Garrett, DiMaggio Charles, Grudzen Corita, Chodosh Joshua, Konda Sanjit
Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA.
Department of Orthopedic Surgery, New York University Grossman School of Medicine, New York, NY 10016, USA.
Healthcare (Basel). 2023 Apr 15;11(8):1137. doi: 10.3390/healthcare11081137.
The American Society of Anesthesiologists Physical Status (ASA-PS) grade better risk stratifies geriatric trauma patients, but it is only reported in patients scheduled for surgery. The Charlson Comorbidity Index (CCI), however, is available for all patients. This study aims to create a crosswalk from the CCI to ASA-PS. Geriatric trauma cases, aged 55 years and older with both ASA-PS and CCI values (N = 4223), were used for the analysis. We assessed the relationship between CCI and ASA-PS, adjusting for age, sex, marital status, and body mass index. We reported the predicted probabilities and the receiver operating characteristics. A CCI of zero was highly predictive of ASA-PS grade 1 or 2, and a CCI of 1 or higher was highly predictive of ASA-PS grade 3 or 4. Additionally, while a CCI of 3 predicted ASA-PS grade 4, a CCI of 4 and higher exhibited greater accuracy in predicting ASA-PS grade 4. We created a formula that may accurately situate a geriatric trauma patient in the appropriate ASA-PS grade after adjusting for age, sex, marital status, and body mass index. In conclusion, ASA-PS grades can be predicted from CCI, and this may aid in generating more predictive trauma models.
美国麻醉医师协会身体状况(ASA - PS)分级能更好地对老年创伤患者进行风险分层,但仅在计划进行手术的患者中报告。然而,查尔森合并症指数(CCI)适用于所有患者。本研究旨在创建一个从CCI到ASA - PS的对照表。分析使用了年龄在55岁及以上、同时具有ASA - PS和CCI值的老年创伤病例(N = 4223)。我们评估了CCI与ASA - PS之间的关系,并对年龄、性别、婚姻状况和体重指数进行了调整。我们报告了预测概率和受试者工作特征。CCI为零高度预测ASA - PS 1级或2级,CCI为1或更高高度预测ASA - PS 3级或4级。此外,虽然CCI为3预测ASA - PS 4级,但CCI为4及更高在预测ASA - PS 4级时表现出更高的准确性。我们创建了一个公式,在对年龄、性别、婚姻状况和体重指数进行调整后,可以准确地将老年创伤患者置于适当的ASA - PS分级中。总之,ASA - PS分级可以从CCI预测,这可能有助于生成更具预测性的创伤模型。