一般内科医生的ASA身体状况确定以及对心脏风险评估的影响
Kevin R Riggs1, Terrance Shaneyfelt1, Andrea L Cherrington1
1From the Departments of Medicine.
Southern medical journal
|July 3, 2023
概括
一般内科医生通常比麻醉师更低的美国麻醉学会 (ASA) 身体状况得分. 这些ASA得分的差异可以显著改变患者的心脏风险估计.
科学领域:
- 麻醉学 麻醉学
- 内部医学 内部医学
- 心脏病学 心脏病学
背景情况:
- 准确的心脏风险估计对于术前患者评估至关重要.
- 美国麻醉学会 (ASA) 的身体状况评分经常用于心脏风险计算器.
- 在ASA得分分配的变化可能会影响患者风险分层.
研究的目的:
- 评估一般内科医生和麻醉师分配的ASA分数之间的一致性.
- 为了确定ASA得分的差异是否会影响心脏风险估计.
主要方法:
- 一项涉及军事退伍军人进行手术前评估的观察性研究.
- 综合内科住院医生和麻醉科医生分配的ASA分数的比较.
- 基于两组ASA分数的古普塔心脏风险分数的计算.
主要成果:
- 内科医生和麻醉师ASA分数之间的一致性低 (37.3%).
- 内部医生在62.0%的病例中分配了较低的分数,具有较低的interrater可靠性 (κ = 0.08).
- 这些差异导致了不同的心脏风险概况,较少的患者使用内科医生指定的得分风险超过1%.
结论:
- 一般内科医生倾向于与麻醉科医生相比分配明显较低的ASA分数.
- 这些ASA评分的系统差异可能导致心脏风险评估的差异很大.
- 标准化ASA分数分配对于准确的手术前心脏风险评估至关重要.
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