Abstract

Background: The American Society of Anesthesiologists (ASA) grade has been used for over 50 years as a risk predictor of peri-operative morbidity and mortality. This measure may also be a predictor of endoscopy related complications, but has not yet been validated. The CORI endoscopic database has included the ASA grade as a query for endoscopic practitioners. There are 5 designated levels, from Class I-healthy patient without comorbidity to Class V- moribund patient with little chance of survival. Little is currently known about endoscopists' understanding and use of this classification system. Purpose:to assess the comprehension and utilization of the ASA grade among a large, heterogeneous group of endoscopists. Methods: All CORI sites were surveyed regardignt their use of the ASA classification and were asked to grade 5 hypothetical patients. Demographic information concerning practice type, training and years since feloowship were collectd for all responding endoscopists. Results: 41 sites and 124 providers responded to the survey. 87% were gastroenterologists, 51% at non-academic sites. 84% stated that they used the ASA classification all or most of the time. 12% utilized the CORI help feature to explain ASA classification. Overall correct grading for the hypothetical patients was 69%. This ranged from 49-98% for the 5 cases. 95% of the responses were within 1 grade of the correct response. Endoscopists using CORI for >12 months were more likely (p

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