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Published on: October 16, 2013
Application of a uniform anatomic grading system to measure disease severity in eight emergency general surgical
Marie L Crandall1, Suresh Agarwal, Peter Muskat
1From the Departments of Surgery-Trauma/Critical Care (M.L.C.) and Preventive Medicine (M.L.C.), Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Surgery (S.A.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Surgery (P.M.), University of Cincinnati, Cincinnati, Ohio; Department of Surgery (S.R.), Cooper Medical School of Rowan University, Camden, New Jersey; Department of Surgery (S.Sa.), University of Tennessee Health Science Center, Memphis, Tennessee; Department of Surgery (K.S.), Yale School of Medicine, New Haven, Connecticut; Department of Surgery (GTT), Scripps Memorial Hospital La Jolla, La Jolla, California; Baylor Institute for Health Care Research and Improvement (S.Sh.), Dallas, Texas.
Background:
Emergent general surgical diseases encompass a broad spectrum of anatomy and pathophysiology, creating challenges for outcomes assessment, research, and surgical training. The goal of this study was to measure anatomic disease severity for eight emergent general surgical diseases using the uniform grading system of the American Association for the Surgery of Trauma (AAST).
Methods:
The Committee on Patient Assessment and Outcomes of AAST applied the previously developed uniform grading system to eight emergent general surgical diseases using a consensus of experts. It was then reviewed and approved by the Board of Managers of AAST.
Results:
Severity grades for eight commonly encountered emergent general surgical conditions were created: breast abscess, esophageal perforation, infectious colitis, pelvic inflammatory disease, perirectal abscess, pleural space infections, soft tissue infections, and surgical site infections. The range of grades from I through V, reflect progression from mild disease, limited to within the organ itself, to widespread severe disease.
Conclusion:
This article provides a uniform grading system for measuring anatomic severity of eight emergent general surgical diseases. Consistent adoption of these grades could improve standardization for quality assurance, outcomes research, and surgical training.
