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Predicting Perioperative Mortality Using ASA Classification & Cardiac Risk Index

Purpose: To predict perioperative mortality for a patient from the ASA class and cardiac risk index.

Description

Peri-operative mortality for patients having elective noncardiac surgery can be predicted from the patient's ASA class and cardiac risk index. This information can provide patients a better understanding of their operative risk, and can identify those patients requiring closer monitoring and care post-operatively.


Patient population:

(1) patients undergoing elective noncardiac surgery

(2) patients undergoing abdominal aortic surgery had a higher morbidity and mortality rate

(3) peri-operative mortality included all patients dying within 4 weeks of operative procedure

 

ASA classes:

(1) Patients were in classes 1 to 4.

(2) Patients in class 5 have a very high mortality rate; they are unlikely to have elective surgery.

 

Cardiac risk index (Goldman, 1977):: Since patients having emergency surgery were not included in the study group, the maximum cardiac risk index was 49

 

 

Cardiac Risk Index

Group

< 6 points

1

6-12 points

2

13-25 points

3

> 25 points

4

 

 

ASA Class

Cardiac Risk Index Group

Percent Mortality

ASA <= 2

 

0.40%

ASA = 3

CRI group = 1

1.36%

 

CRI group > 1

3.19%

ASA =4

CRI group <= 2

4.40%

 

CRI group > 2

7.29%

 

Interpretation:

• ASA class and cardiac risk group both correlate with peri-operative mortality and both are correlated with each other.

• ASA class is an independent predictor of peri-operative mortality but CRI index is not.


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Specialty

Objective

ICD-10