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评估美国麻醉医师协会(ASA)、推荐意见分级(SORT)和美国矫形外科医师学会(ACCI)评分在预测髋关节手术后入住重症监护病房需求方面的作用。

Evaluation of ASA, SORT, and ACCI Scores in Predicting the Need for Postoperative Intensive Care Unit Admissions After Hip Surgery.

作者信息

Gezer Neslihan, Pirbudak Lütfiye, Şen Elzem, Mızrak Ayşe

机构信息

Gaziantep University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Gaziantep, Türkiye.

出版信息

Turk J Anaesthesiol Reanim. 2025 Jul 24;53(4):157-162. doi: 10.4274/TJAR.2025.241708. Epub 2025 May 14.

Abstract

OBJECTIVE

We aimed to investigate the effectiveness of the American Society of Anesthesiologists (ASA), the Surgical Outcome Risk Tool (SORT), and age-adjusted Charlson Comorbidity Index (ACCI) scores in determining the requirement for intensive care unit (ICU) admissions in patients aged 65 years and older who underwent hip surgery.

METHODS

The study population consisted of 450 patients who underwent orthopedic hip surgery. The patients who were admitted to the ICU were either monitored in the postoperative ICU (Group 1) or transferred to the ward (Group 2). SORT and ACCI scores of all patients were recorded.

RESULTS

The patients of Group 1 were significantly older than those in Group 2. SORT scores of both groups were comparable. The diagnostic sensitivity and specificity of ACCI scores were determined as 42.1% and 70.8%, respectively.

CONCLUSION

As a conclusion, ACCI scores can predict the need for ICU admissions in patients undergoing hip surgery. Besides, the traditionally used ASA scores are generally higher in this patient group. Determinative criteria for predicting the need for ICU admissions include older age of the patients, presence of comorbidities as hypertension and diabetes mellitus, as well as a long preoperative waiting period.

摘要

目的

我们旨在研究美国麻醉医师协会(ASA)评分、外科手术结果风险工具(SORT)评分以及年龄校正的查尔森合并症指数(ACCI)评分在确定65岁及以上接受髋关节手术患者重症监护病房(ICU)收治需求方面的有效性。

方法

研究人群包括450例接受骨科髋关节手术的患者。入住ICU的患者在术后于ICU接受监测(第1组)或转入病房(第2组)。记录所有患者的SORT和ACCI评分。

结果

第1组患者的年龄显著高于第2组。两组的SORT评分相当。ACCI评分的诊断敏感性和特异性分别确定为42.1%和70.8%。

结论

总之,ACCI评分可预测接受髋关节手术患者的ICU收治需求。此外,在该患者群体中,传统使用的ASA评分通常较高。预测ICU收治需求的决定性标准包括患者年龄较大、存在如高血压和糖尿病等合并症以及术前等待期较长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5180/12288435/f7c554ece4b0/TurkJAnaesthesiolReanim-53-4-157-figure-1.jpg

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