The role of the American Society of anesthesiologists physical status classification in predicting trauma mortality and outcomes

Catherine M. Kuza, Kazuhide Matsushima, Wendy J. Mack, Christopher Pham, Talia Hourany, Jessica Lee, Thang D. Tran, Roman Dudaryk, Michelle B. Mulder, Miguel A. Escanelle, Babatunde Ogunnaike, M. Iqbal Ahmed, Xi Luo, Alexander Eastman, Jonathan B. Imran, Emily Melikman, Abu Minhajuddin, Anne Feeler, Richard D. Urman, Ali SalimDean Spencer, Viktor Gabriel, Divya Ramakrishnan, Jeffry T. Nahmias

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Trauma prediction scores such as Revised Trauma Score (RTS) and Trauma and Injury Severity Score (TRISS)) are used to predict mortality, but do not include comorbidities. We analyzed the American Society of Anesthesiologists physical status (ASA PS) for predicting mortality in trauma patients undergoing surgery. Methods: This multicenter, retrospective study compared the mortality predictive ability of ASA PS, RTS, Injury Severity Score (ISS), and TRISS using a complete case analysis with mixed effects logistic regression. Associations with mortality and AROC were calculated for each measure alone and tested for differences using chi-square. Results: Of 3,042 patients, 230 (8%) died. The AROC for mortality for TRISS was 0.938 (95%CI 0.921, 0.954), RTS 0.845 (95%CI 0.815, 0.875), and ASA PS 0.886 (95%CI 0.864, 0.908). ASA PS + TRISS did not improve mortality predictive ability (p = 0.18). Conclusions: ASA PS was a good predictor of mortality in trauma patients, although combined with TRISS it did not improve predictive ability.

Original languageEnglish (US)
Pages (from-to)1143-1151
Number of pages9
JournalAmerican journal of surgery
Volume218
Issue number6
DOIs
StatePublished - Dec 2019

Keywords

  • ASA PS
  • Mortality
  • Outcomes
  • Predictors
  • Trauma scores

ASJC Scopus subject areas

  • Surgery

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    Kuza, C. M., Matsushima, K., Mack, W. J., Pham, C., Hourany, T., Lee, J., Tran, T. D., Dudaryk, R., Mulder, M. B., Escanelle, M. A., Ogunnaike, B., Ahmed, M. I., Luo, X., Eastman, A., Imran, J. B., Melikman, E., Minhajuddin, A., Feeler, A., Urman, R. D., ... Nahmias, J. T. (2019). The role of the American Society of anesthesiologists physical status classification in predicting trauma mortality and outcomes. American journal of surgery, 218(6), 1143-1151. https://doi.org/10.1016/j.amjsurg.2019.09.019