ASA PHYSICAL STATUS AND AGE PREDICT MORBIDITY AFTER 3 SURGICAL-PROCEDURES

Objective American Society of Anesthesiologists-Physical Status scores (ASA-FS) and age were used to adjust for case-mix differences when ev aluating surgical morbidity and resource use alter total hip replaceme nt (THR), transurethral prostatectomy (TURF), or cholecystectomy. Summ ary Background Data Variations in complication rates or resource use a mong patients treated for a particular primary condition should be adj usted for coexistent disease. Age and ASA-PS scores are readily availa ble and can be useful to stratify surgical patients for risk. Methods One thousand ninety patients at five academic medical centers in Calif ornia and Massachusetts who underwent THR, TURF, or cholecystectomy be tween 1985 and 1987 were studied. Data were obtained from medical reco rds and a self-administered questionnaire to measure length of stay (L OS), postoperative complication rates, and follow-up physician visits. Data were analyzed with one- and two-way analysis of variance with th e Bonferroni correction. Results Increasing age and ASA-FS scores were associated significantly with increased LOS, complication rates, and frequency of post-discharge physician office visits. No interaction ef fect between age and ASA-PS scores was observed. Conclusions Age and A SA-PS scores can predict postoperative morbidity, specific for each op eration studied. Assessment of co-morbidity in surgical patients can b e accomplished easily and with minimal expense. While remaining budget neutral, the distribution of reimbursements should be based on those preoperative risk factors that predict longer LOS and higher complicat ion rates.