American Society of Anesthesiologists Class as Predictor for Perioperative Morbidity in Head and Neck Free Flaps.
Objective: To evaluate outcomes of free flaps in low- versus high-risk American Society of Anesthesiologists (ASA) classes utilizing a standardized perioperative clinical pathway.Study Design: Case series with chart review.Setting: Single tertiary care academic institution.Subjects and Methods: Data...
| Publicado en: | Otolaryngology-Head & Neck Surgery Vol. 161; no. 1; pp. 91 - 98 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137288873&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137288873 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01945998 22O jtl: Otolaryngology-Head & Neck Surgery issn: 01945998 maglogo: N pubinfo: dt: Jul2019 vid: 161 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 137288873 137288873 NLM30912990 137288873 10.1177/0194599819832812 NLM30912990 137288873 ppf: 91 ppct: 7 formats: tig: atl: American Society of Anesthesiologists Class as Predictor for Perioperative Morbidity in Head and Neck Free Flaps. aug: au: Small, Luke T. Lampkin, Madison Vural, Emre Moreno, Mauricio A. affil: Department of Otolaryngology–Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA sug: subj: Surgery, Reconstructive Methods Health Status Indicators Head Surgery Surgical Flaps Neck Surgery Arkansas Middle Age Retrospective Design Male Postoperative Complications Epidemiology Critical Path Standards Female Graft Survival Comorbidity Readmission Statistics and Numerical Data Patient Discharge Length of Stay Statistics and Numerical Data Adult Human Middle Aged: 45-64 years Adult: 19-44 years Male Female ab: Objective: To evaluate outcomes of free flaps in low- versus high-risk American Society of Anesthesiologists (ASA) classes utilizing a standardized perioperative clinical pathway.Study Design: Case series with chart review.Setting: Single tertiary care academic institution.Subjects and Methods: Data were collected from 301 patients who underwent 305 free flap reconstructions for head and neck defects from January 2012 to March 2016 by a single surgeon (M.M.). A standardized perioperative clinical pathway was utilized for all patients, aimed at abbreviating hospital stay and minimizing intensive care unit stay. Data included ASA classification, comorbidities, length of hospitalization, intensive care unit stay, 30-day mortality/readmission, discharge disposition, flap survival, and postoperative complications. Low-risk ASA classes were defined as 1 and 2 (n = 53) and high risk as 3 and 4 (n = 248).Results: Total medical complication rates (P = .012) were mildly increased in the high-risk group, as a result of increased minor-not major-medical complication rates (P = .007). Discharge to a nursing or rehabilitation facility was found to be more common in the high-risk group (P = .024). All other outcomes were not statistically different between the cohorts.Conclusion: The ASA classification system is a validated tool in determining perioperative risk. We found that minor medical complications and discharge to a rehabilitation/nursing facility were increased in the high-risk ASA classes; otherwise, there were no statistical differences between the groups. These findings suggest that the ASA classification may be helpful for preoperative discharge planning and counseling but should not be used for patient selection or to assess candidacy for the procedure. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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