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Preoperative assessment and mortality in geriatric patients

Laso, M. J.; Gordo, F.; Fernández, D.; Solá, J.; Moral, V.

European Journal of Anaesthesiology: 2000 - Volume 17 - Issue - p 1
European Society of Anaesthesiologists; 8th Annual Meeting with the Austrian International Congress; Vienna, Austria, 1-4 April 2000
Free

Departments of Anesthesiology and Epidemiology, Hospital de Sabadell CSPT, Barcelona, Spain

Abstract A-2

Background and goal of study: To compare the accuracy of two scales ASA and Mannheim (MAN) when they were used to assess the anaesthetic risk in the elderly patient. To establish the relationship between the anaesthetic risk and the perioperative mortality.

Methods: The study comprised 326 patients affected by hip fracture who underwent orthopaedic surgery. Preoperative evaluation included clinical history, physical examination, ECG, chest radiography and blood analysis. ASA and MAN were allocated according to physical status. Mortality was recorded one year after surgery. Correlation between ASA and MAN was obtained from Rho Spearman. Death risk was established for every degree of ASA and MAN by logistic regression. Kappa index analysed concordance degree for every one of both scales.

Results: Distribution of patients according to ASA and MAN was the following: 21.1% ASA II, 62.9 % ASA III, 16% ASA IV and 3.3% MAN II, 62.3% MAN III, 34.4% MAN IV. Correlation between ASA and MAN was P=0.52. One year after surgery 21.5% of patients had died. Mortality was higher for ASA III than ASA IV (Table 1). Concordance degree for ASA and MAN was 0.77 and 0.89 respectively.

Table 1

Table 1

Conclusion: There is correlation between ASA and MAN. ASA underrates physical status and the anaesthetic risk. Man is an objective scale and allows a greater concordance between anaesthesiologists. Man is more accurate to determinate the anaesthetic risk.

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Reference:

1 Ranta S, Hynynen M, Tamisto T. Acta Anaesthesiol Scand 1997; 41: 629-632.

    Section Description

    The abstracts published in this supplement have been typeset from camera-ready copies prepared by the authors. Every effort has been made to reproduce faithfully the abstracts as submitted. However, no responsibility is assumed by the organisers for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of methods, products, instructions or ideas contained in the material herein. Because of the rapid advances in medical sciences, we recommend that independent verification of diagnoses and drug doses should be made.

    Epidemiology in anaesthesia and intensive care

    © 2000 European Society of Anaesthesiology