The role of the American Society of anesthesiologists physical status classification in predicting trauma mortality and outcomes.
ASA PS
Mortality
Outcomes
Predictors
Trauma scores
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
07
03
2019
revised:
22
08
2019
accepted:
18
09
2019
pubmed:
3
10
2019
medline:
10
3
2020
entrez:
3
10
2019
Statut:
ppublish
Résumé
Trauma prediction scores such as Revised Trauma Score (RTS) and Trauma and Injury Severity Score (TRISS)) are used to predict mortality, but do not include comorbidities. We analyzed the American Society of Anesthesiologists physical status (ASA PS) for predicting mortality in trauma patients undergoing surgery. This multicenter, retrospective study compared the mortality predictive ability of ASA PS, RTS, Injury Severity Score (ISS), and TRISS using a complete case analysis with mixed effects logistic regression. Associations with mortality and AROC were calculated for each measure alone and tested for differences using chi-square. Of 3,042 patients, 230 (8%) died. The AROC for mortality for TRISS was 0.938 (95%CI 0.921, 0.954), RTS 0.845 (95%CI 0.815, 0.875), and ASA PS 0.886 (95%CI 0.864, 0.908). ASA PS + TRISS did not improve mortality predictive ability (p = 0.18). ASA PS was a good predictor of mortality in trauma patients, although combined with TRISS it did not improve predictive ability.
Sections du résumé
BACKGROUND
Trauma prediction scores such as Revised Trauma Score (RTS) and Trauma and Injury Severity Score (TRISS)) are used to predict mortality, but do not include comorbidities. We analyzed the American Society of Anesthesiologists physical status (ASA PS) for predicting mortality in trauma patients undergoing surgery.
METHODS
This multicenter, retrospective study compared the mortality predictive ability of ASA PS, RTS, Injury Severity Score (ISS), and TRISS using a complete case analysis with mixed effects logistic regression. Associations with mortality and AROC were calculated for each measure alone and tested for differences using chi-square.
RESULTS
Of 3,042 patients, 230 (8%) died. The AROC for mortality for TRISS was 0.938 (95%CI 0.921, 0.954), RTS 0.845 (95%CI 0.815, 0.875), and ASA PS 0.886 (95%CI 0.864, 0.908). ASA PS + TRISS did not improve mortality predictive ability (p = 0.18).
CONCLUSIONS
ASA PS was a good predictor of mortality in trauma patients, although combined with TRISS it did not improve predictive ability.
Identifiants
pubmed: 31575418
pii: S0002-9610(19)30254-5
doi: 10.1016/j.amjsurg.2019.09.019
pmc: PMC8421011
mid: NIHMS1729266
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1143-1151Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000130
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001855
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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