Predicting the risk of intraoperative cardiovascular complications with physical status-anesthesia-surgery method and American Society of Anesthesiologists Physical Status Classification

Abstract

Objective To develop a new method to predict the risk of intraoperative cardiovascular complications. Methods American Society of Anesthesiologists Physical Status Classification(ASA-PS) and Carrillo′s risk classification were selected as the risk evaluation criteria for physical status, and anesthesia and surgery status, respectively. Preoperative risk assessment and grading were carried out in 3 543 surgical patients. The intraoperative cardiovascular complications were recorded. The risk of cardiovascular complications in patients with different classifications in the physical status, and anesthesia and surgery status were analyzed with Logistic analysis and the regression coefficients were obtained. The Logistic regression coefficient was used to establish a mathematical model, which was compared with ASA-PS model. Results Three hundred and eleven intraoperative cardiovascular complication (8.78%) occurred in 3 543 patients. According to the Logistic analysis, the risk of the complications include classifications of physical status, anesthesia and surgery elements with coefficients of 0.886, 0.508 and 0.268, respectively, the coefficient of the ASA-PS was 1.089. The equation of the three-in-one model was logit(P)=-6.298+0.886×ASA-PS+0.508×anesthesia grade+0.268×surgical grade. The equation of the ASA-PS model is logit(P)=-4.758+1.089×ASA-PS. The area under the receiver operating characteristic curve (ROC) is 0.809 in the three-in-one model and is 0.732 in ASA-PS model. Conclusions The new method of physical status-anesthesia-surgery three-in-one risk assessment is better than ASA-PS model to predict intraoperative cardiovascular complications. Key words: Surgery; Anesthesia; Risk assessment; Risk prediction; Complication; American Society of Anesthesiologists Physical Status Classification