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American Society of Anesthesiologists Score: Still Useful After 60 Years? Results of the EuSOS Study

dc.contributor.authorMoreno, R
dc.contributor.authorPearse, R
dc.contributor.authorRhodes, A
dc.date.accessioned2015-12-03T17:27:26Z
dc.date.available2015-12-03T17:27:26Z
dc.date.issued2015
dc.description.abstractOBJECTIVE: The European Surgical Outcomes Study described mortality following in-patient surgery. Several factors were identified that were able to predict poor outcomes in a multivariate analysis. These included age, procedure urgency, severity and type and the American Association of Anaesthesia score. This study describes in greater detail the relationship between the American Association of Anaesthesia score and postoperative mortality. METHODS: Patients in this 7-day cohort study were enrolled in April 2011. Consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery with a recorded American Association of Anaesthesia score in 498 hospitals across 28 European nations were included and followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Decision tree analysis with the CHAID (SPSS) system was used to delineate nodes associated with mortality. RESULTS: The study enrolled 46,539 patients. Due to missing values, 873 patients were excluded, resulting in the analysis of 45,666 patients. Increasing American Association of Anaesthesia scores were associated with increased admission rates to intensive care and higher mortality rates. Despite a progressive relationship with mortality, discrimination was poor, with an area under the ROC curve of 0.658 (95% CI 0.642 - 0.6775). Using regression trees (CHAID), we identified four discrete American Association of Anaesthesia nodes associated with mortality, with American Association of Anaesthesia 1 and American Association of Anaesthesia 2 compressed into the same node. CONCLUSION: The American Association of Anaesthesia score can be used to determine higher risk groups of surgical patients, but clinicians cannot use the score to discriminate between grades 1 and 2. Overall, the discriminatory power of the model was less than acceptable for widespread use.pt_PT
dc.identifier.citationRev Bras Ter Intensiva. 2015 Apr-Jun;27(2):105-12pt_PT
dc.identifier.doi10.5935/0103-507X.20150020pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2348
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherPubmed Centralpt_PT
dc.subjectHSJ UCIpt_PT
dc.subjectAnesthesiologypt_PT
dc.subjectCohort Studiespt_PT
dc.subjectDecision Treespt_PT
dc.subjectEuropept_PT
dc.subjectFollow-Up Studies
dc.subjectHealth Status
dc.subjectHospital Mortality
dc.subjectPostoperative Complications/mortality
dc.subjectSocieties, Medical
dc.subjectUnited States
dc.titleAmerican Society of Anesthesiologists Score: Still Useful After 60 Years? Results of the EuSOS Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage112pt_PT
oaire.citation.startPage105pt_PT
oaire.citation.titleRevista Brasileira de Terapia Intensivapt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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