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American Society of Anesthesiologists class and Charlson's comorbidity index as predictors of postoperative colorectal anastomotic leak: a single-institution experience


, : American Society of Anesthesiologists class and Charlson's comorbidity index as predictors of postoperative colorectal anastomotic leak: a single-institution experience. Journal of Surgical Research 184(1): 115-119

The American Society of Anesthesiologists (ASA) physical status classification and Charlson comorbidity index (CCI) was adopted to assess patients' physical condition before surgery. Studies suggest that ASA score and CCI might be a prognostic criterion (indicator) for patient outcome. The aim of this study is to determine if ASA classification and CCI can determine the risk of anastomotic leaks (AL) in patients who underwent colorectal surgery. A retrospective analysis of 505 consecutive colorectal resections with primary anastomoses between 2008 and 2012 was performed at a university hospital. ASA score, CCI, surgical procedure, length of stay, age, body mass index (BMI), comorbidities, and postoperative outcomes were analyzed. Two hundred sixty-five patients had an ASA score of I and II, 227 patients had an ASA score of III, and 13 patients had an ASA score of IV. A total of 19 patients had an anastomotic leak (ASA I-II: 5 patients, 1.9%; ASA III: 12 patients, 5.58%; ASA IV: 2 patients, 18.18%). A higher ASA score was significantly associated with AL on further analysis (OR: 2.99, 95% CI: 1.345-6.670, P = 0.007). When matched for age, BMI, and CCI on logistic regression analysis, increased ASA level was independently related to an increased likelihood of leak (OR(steroids) = 14.35, P < 0.01; OR(ASA_III v I-II) = 2.02, P = 0.18; OR(ASA_IVvI-II) = 8.45, P = 0.03). There were no statistically significant differences in means between the leak and no-leak patients with respect to age (60.69 versus 65.43, P = 0.17), BMI (28.03 versus 28.96, P = 0.46), and CCI (6.19 versus 7.58, P = 0.09). ASA score, but not CCI, is independently associated with anastomotic leak. Patients with a high ASA class should be closely followed postoperatively for AL after colorectal operations.

US$19.90

PMID: 23830360

DOI: 10.1016/j.jss.2013.05.039


Other references

Basler, K.; Yen, D.; Tomlinson, A.; Hafen, E., 1990: Reprogramming cell fate in the developing Drosophila retina: transformation of R7 cells by ectopic expression of rough. In the developing eye of Drosophila, the homeo box gene rough is required in the developing photoreceptor cells R2 and R5 for the correct development of the neighboring R3 and R4 cells. We have expressed rough ectopically in a limited subset of de...

Huang, K.X.; Walters, J.R., 1996: Dopaminergic regulation of AP-1 transcription factor DNA binding activity in rat striatum. Dopaminergic modulation of the DNA binding activity of AP-1, Sp1, CREB and AP-2 transcription factors was examined in rat striatal nuclear extracts by gel shift assay. AP-1 binding was selectively increased in the striatum following depletion of d...

Rumbold, P.L.S.; S.C.air Gibson, A.; Stevenson, E.J.; King, J.A.; Stensel, D.J.; Dodd-Reynolds, C.J., 2016: Influence of netball-based exercise on energy intake, subjective appetite and plasma acylated ghrelin in adolescent girls. This study explored 5-day regulation of exercise-induced energy expenditure, energy intake, and hormonal appetite, via acylated ghrelin, after acute exercise. Using a randomized crossover design, 10 female adolescents (13-15 years old) completed t...

Berger, WH., 1981: The 1980 Joseph A. Cushman Award. Fred B. Phleger. Journal of Foraminiferal Research, 114: 260-261

Broksh, V.L., 1972: Sterility of haploid plants of Solanum tuberosum L. A collection of 48 haploids was classified according to their flowering habit; only two had a low percentage of abortive pollen and five had female fertility. Various meiotic irregularities in the haploids are described; their degree was not corre...

Roshanfekr, D.; Kester, M.; Grier, R.; Mackenzie, A.; Funai, E.; Rebarber, A., 2001: Incidence of false positive triple screens for Down syndrome in two consecutive pregnancies in non-advanced maternal age patients who underwent amniocentesis for each pregnancy. American Journal of Obstetrics & Gynecology 185(6 Supplement): S225, December

Steinbacker, J., 1951: Besuch auf Oland. Natur und Volk, 81: 65-73

Feklisova, L.V.; Kurnosova, N.A.; Mashikhina, N.D.; Tagieva, O.Sh.; Verigo, N.A., 1971: The effectiveness of treating dysentery reconvalescents with milk colibacterin. Voprosy Okhrany Materinstva i Detstva 16(9): 63-65

Ando S.; Kametani H.; Osada H.; Iwamoto M.; Kimura N., 1987: Delayed memory dysfunction by transient hypoxia and its prevention with forskolin. Rats exposed to 40 min hypoxia 3 h before a one-trial learning passive avoidance task showed impaired memory retention 24 h later. This model was used to assess the ability of forskolin to restore the delayed memory dysfunction. Significant amelio...

Christensen, J., F.; Allen, E., A., 1942: Coccidiosis of the Chicken. Yearbook of agriculture: 041-1047