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 Citation (Scopus)

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)
JournalAmerican journal of surgery
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Injury Severity Score
Mortality
Wounds and Injuries
Anesthesiologists
Multicenter Studies
Comorbidity
Retrospective Studies
Logistic Models

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

The role of the American Society of anesthesiologists physical status classification in predicting trauma mortality and outcomes. / Kuza, Catherine M.; Matsushima, Kazuhide; Mack, Wendy J.; Pham, Christopher; Hourany, Talia; Lee, Jessica; Tran, Thang D.; Dudaryk, Roman; Mulder, Michelle B.; Escanelle, Miguel A.; Ogunnaike, Babatunde; Ahmed, M. Iqbal; Luo, Xi; Eastman, Alexander; Imran, Jonathan B.; Melikman, Emily; Minhajuddin, Abu; Feeler, Anne; Urman, Richard D.; Salim, Ali; Spencer, Dean; Gabriel, Viktor; Ramakrishnan, Divya; Nahmias, Jeffry T.

In: American journal of surgery, 01.01.2019.

Research output: Contribution to journalArticle

Kuza, CM, Matsushima, K, Mack, WJ, Pham, C, Hourany, T, Lee, J, Tran, TD, Dudaryk, R, Mulder, MB, Escanelle, MA, Ogunnaike, B, Ahmed, MI, Luo, X, Eastman, A, Imran, JB, Melikman, E, Minhajuddin, A, Feeler, A, Urman, RD, Salim, A, Spencer, D, Gabriel, V, Ramakrishnan, D & Nahmias, JT 2019, 'The role of the American Society of anesthesiologists physical status classification in predicting trauma mortality and outcomes', American journal of surgery. https://doi.org/10.1016/j.amjsurg.2019.09.019
Kuza, Catherine M. ; Matsushima, Kazuhide ; Mack, Wendy J. ; Pham, Christopher ; Hourany, Talia ; Lee, Jessica ; Tran, Thang D. ; Dudaryk, Roman ; Mulder, Michelle B. ; Escanelle, Miguel A. ; Ogunnaike, Babatunde ; Ahmed, M. Iqbal ; Luo, Xi ; Eastman, Alexander ; Imran, Jonathan B. ; Melikman, Emily ; Minhajuddin, Abu ; Feeler, Anne ; Urman, Richard D. ; Salim, Ali ; Spencer, Dean ; Gabriel, Viktor ; Ramakrishnan, Divya ; Nahmias, Jeffry T. / The role of the American Society of anesthesiologists physical status classification in predicting trauma mortality and outcomes. In: American journal of surgery. 2019.
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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.",
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AU - Kuza, Catherine M.

AU - Matsushima, Kazuhide

AU - Mack, Wendy J.

AU - Pham, Christopher

AU - Hourany, Talia

AU - Lee, Jessica

AU - Tran, Thang D.

AU - Dudaryk, Roman

AU - Mulder, Michelle B.

AU - Escanelle, Miguel A.

AU - Ogunnaike, Babatunde

AU - Ahmed, M. Iqbal

AU - Luo, Xi

AU - Eastman, Alexander

AU - Imran, Jonathan B.

AU - Melikman, Emily

AU - Minhajuddin, Abu

AU - Feeler, Anne

AU - Urman, Richard D.

AU - Salim, Ali

AU - Spencer, Dean

AU - Gabriel, Viktor

AU - Ramakrishnan, Divya

AU - Nahmias, Jeffry T.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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