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2022, Number 3

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Rev Mex Anest 2022; 45 (3)

SASA: a simple scale of postoperative mortality explored in a third-level care center in Mexico

Rascón-Martínez DM, Jiménez-Patraca DJ, Cuevas-Fuentes GJ, Pinto-Angulo VM, Castellanos-Olivares A, Carrillo-Torres O

Language: Spanish
References: 27
Page: 178-183
PDF size: 289.83 Kb.


ABSTRACT

Introduction: Post-surgical complications have been a significant cause of death. Therefore, the use of easy preoperative mortality predictors is recommended. A new SASA score could indicate a perioperative risk more globally at 30-days of the postoperative period applied in a Mexican sample. Material and methods: 371 patients were analyzed. We explore an association between the American Society of Anesthesiologists physical status classification (ASA-PS), the surgical Apgar score (sAs), and the new SASA score to assess 30-days mortality after surgery using univariate analysis to estimate the odds ratio (OR). Receiver-operating-characteristic (ROC) curves were plotted for each scale. Results: We obtained values of two; [sensitivity; 81.82% (95% CI: 48.2-97.72), specificity; 40.56% (95% CI: 35.44-45.83)] 6; [sensitivity; 81.82% (95% CI: 48.2-97.72), specificity; 77.5% (95% CI: 72.83-81.71)] and 10; [sensitivity; 81.82% (95% CI: 48.2-97.72), specificity; 83.6% (95% CI: 78.77-86.78)] as the best cut-off points for ASA-PS, sAs and SASA respectively. Conclusions: To predict postoperative 30-days mortality, SASA calculation as a new score obtained the same sensitivity but better specificity and area under the curve (AUC) for the ROC compared with the ASA-PS and the sAs.


REFERENCES

  1. Valdespino JL, Olaiz G, López-Barajas MP, et al. Encuesta Nacional de Salud 2000. Tomo I. Vivienda, población y utilización de servicios de salud. Cuernavaca, Morelos, México. Instituto Nacional de Salud Pública. 2003.

  2. Sistema Nacional de Información en Salud (SINAIS). Secretaría de Salud. Disponible en: http://sinais.salud.gob.mx

  3. Moar JJ. Anaesthetic associated mortality and anaesthetic contributory death: the South African medico-legal approach. Forensic-Sci-Sci-Int. 1996;78:219-230.

  4. Secretari?a de Salud. Informe sobre la Salud de los Mexicanos 2015. Diagnóstico General de la Salud Poblacional. Dirección General de Evaluación del Desempeño. 2015.

  5. Oliver CM, Walker E, Giannaris S, et al. Risk assessment tools validated for patients undergoing emergency laparotomy: a systematic review. Br J Anaesth. 2015;115:849-860.

  6. Yurtlu DA, Aksun M, Ayvat P, et al. Comparison of risk scoring systems to predict the outcome in ASA-PS V patients undergoing surgery: a retrospective cohort study. Medicine. 2016;95:e3238.

  7. Pantoja Muñoz HJ, Fernández Ramos H, Guevara Tovar WL. Sensitivity, specificity and predictive values of the Goldman, Detsky and Lee cardiac indices. Rev Colomb Anestesiol. 2014;42:184-191.

  8. Tan WP, Talbott VA, Leong QQ, et al. American society of anesthesiologists class and Charlson's comorbidity index as predictors of postoperative colorectal anastomotic leak: a single-institution experience. J Surg Res. 2013;184:115-119.

  9. Saklad M. Grading of patients for surgical procedures. Anesthesiol. 1941; 2:281-284.

  10. ASA physical classification system. American Society of Anesthesiologists. 2020. Available in: https://www.asahq.org/Home/For-Members/Clinical-Information/ASA-Physical-Status-Classification-System/

  11. Sidi A, Lobato EB, Cohen JA. The American Society of Anesthesiologists' physical status: category V revisited. J Clin Anesth. 2000;12:328-334.

  12. Davenport DL, Bowe EA, Henderson WG, et al. National surgical quality improvement program (NSQIP) risk factors can be used to validate American Society of Anesthesiologists physical status classification (ASA PS) levels. Ann Surg. 2006;243:636-641;discussion 641-644.

  13. Visnjevac O, Davari-Farid S, Lee J, et al. The effect of adding functional classification to ASA status for predicting 30-day mortality. Anesth Analg. 2015;121:110-116.

  14. Gawande AA, Kwaan MR, Regenbogen SE, et al. An Apgar score for surgery. J Am Coll Surg. 2007;204:201-208.

  15. Wuerz TH, Regenbogen SE, Ehrenfeld JM, et al. The surgical Apgar score in hip and knee arthroplasty. Clin Orthop Relat Res. 2011;469:1119-1126.

  16. Clark RM, Lee MS, Alejandro Rauh-Hain J, et al. Surgical Apgar score and prediction of morbidity in women undergoing hysterectomy for malignancy. Gynecol Oncol. 2015;136:516-520.

  17. Lau D, Yee TJ, La Marca F, et al. Utility of the surgical Apgar score for patients who undergo surgery for spinal metastasis. Clin Spine Surg. 2017;30:374-381.

  18. Stroyer S, Mantoni T, Svendsen LB. Evaluation of the surgical apgar score in patients undergoing Ivor-Lewis esophagectomy. J Surg Oncol. 2017;115:186-191.

  19. Ettinger KS, Moore EJ, Lohse CM, et al. Application of the surgical Apgar score to microvascular head and neck reconstruction. J Oral Maxillofac Surg. 2016;74:1668-1677.

  20. Reynolds PQ, Sanders NW, Schildcrout JS, et al. Expansion of the surgical Apgar score across all surgical subspecialties as a means to predict postoperative mortality. Anesthesiology. 2011;114:1305-1312.

  21. Kinoshita M, Morioka N, Yabuuchi M, et al. New surgical scoring system to predict postoperative mortality. J Anesth. 2017;31:198-205.

  22. Instituto Mexicano del Seguro Social. Memoria Estadística 2015. Disponible en: http://www.imss.gob.mx/conoce-al-imss/memoria-estadistica-2015

  23. Koo CY, Hyder JA, Wanderer JP, et al. A meta-analysis of the predictive accuracy of postoperative mortality using the American Society of Anesthesiologists' physical status classification system. World J Surg. 2015;39:88-103.

  24. Vacanti CJ, VanHouten RJ, Hill RC. A statistical analysis of the relationship of physical status to postoperative mortality in 68,388 cases. Anesth Analg 1970; 49:564–566

  25. Miki Y, Tokunaga M, Tanizawa Y, et al. Perioperative risk assessment for gastrectomy by surgical apgar score. Ann Surg Oncol. 2014;21:2601-2607.

  26. Thorn CC, Chan M, Sinha N, et al. Utility of the surgical Apgar score in a district general hospital. World J Surg. 2012;36:1066-1073.

  27. Dalton JE, Kurz A, Turan A, et al. Development and validation of a risk quantification index for 30-day postoperative mortality and morbidity in noncardiac surgical patients. Anesthesiol. 2011;114:1336-1344.




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