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A new and feasible model for predicting operative risk.
1Department of Neuroscience, Anaesthesia and Intensive Care Unit, Marche Polytechnic University, Ancona, Italy. donati@indi.it
British Journal of Anaesthesia
|June 29, 2004
Summary
A new model using American Society of Anesthesiologists (ASA) status predicts operative mortality risk. This simple, ASA status-based model is suitable for routine clinical use in predicting surgical risk.
Area of Science:
- Anesthesiology
- Surgical Risk Assessment
- Predictive Modeling
Background:
- The Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) score is complex for immediate clinical use.
- A need exists for a simpler method to calculate operative risk.
Purpose of the Study:
- To develop and validate a new, simplified model for predicting operative mortality.
- The model is based on American Society of Anesthesiologists (ASA) status.
Main Methods:
- Data from 1936 surgical patients were used for model development and 1849 for validation.
- Forward stepwise logistic regression was employed.
- The new model was compared to POSSUM, P-POSSUM, and ASA status alone.
Main Results:
- The new model includes ASA status, age, type of surgery, and degree of surgery.
- The ASA status-based model demonstrated good calibration and discrimination.
- It showed better calibration than POSSUM and P-POSSUM, and better discrimination than ASA alone.
Conclusions:
- A new, ASA status-based model effectively predicts operative risk.
- This model is simple and can be routinely used in the operating room.
- It is applicable to both elective and emergency surgeries.