8/10/2023 0 Comments Asa class![]() ![]() ![]() The NSQIP database from 2010 to 2014 was used in this study. This study seeks to help resolve these conflicts from previous works by investigating the capability of ASA class to predict adverse postoperative events using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. 14 However, Tang et al identified ASA class to be an independent risk factor for major complications in ASD surgery, while Pateder et al also found an association between a higher ASA class ranking and patient mortality. Schwab et al conducted a multicenter, retrospective study of ASD patients and found no significant differences in ASA class between the cohorts with complications and without complications. Prior literature exploring the utility of preoperative factors, especially ASA class, in ASD surgery has conflicting results ( Table 1). 6 – 13 Because the score is assigned preoperatively based on the patient’s preoperative health, ASA classifications have the potential to be an accessible tool for surgeons to gauge patient risk for postoperative complications. However, since then, multiple studies have demonstrated and emphasized its potential as a useful proxy for judging patients’ operative risk and as a predictor for postoperative complications, particularly in spinal surgeries. 5 The original goal of the ASA class system was to assess overall preoperative physical status of the patient and not surgical risk per se because it does not include the impact of surgery on the patient’s outcomes. The American Society of Anesthesiologists (ASA) Physical Status classification system was originally developed as a variable for statistical tabulations. 3 Although there are continued developments in techniques, instrumentation, and anesthesia in the realm of ASD surgery, 3, 4 the increasing emphasis on cost containment and restructuring of compensation schemes have prioritized the utility of potential risk stratification tools to predict complications and improve perioperative planning and management. 2 Additionally, conservative estimates of complications from ASD surgery tally to $5.4 billion, with complication rates ranging from 13% to 59%. The United States Bone and Joint Initiative estimates a total of $75.8 billion in hospital discharge costs related to spinal deformity disorders, with 65% of that cost being derived from scoliosis, spondylolisthesis, and other spondylopathies. As the elderly population in the United States continues to rise and is projected to nearly double by 2050, 1 adult spinal deformity (ASD) is becoming increasingly prevalent. ![]()
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