Bc. Reid et al., The American Society of Anesthesiologists' class as a comorbidity index ina cohort of head and neck cancer surgical patients, HEAD NECK, 23(11), 2001, pp. 985-994
Citations number
33
Categorie Soggetti
Otolaryngology
Journal title
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Background. We assessed the American Society of Anesthesiologists' (ASA) cl
ass, as a measure of comorbidity in comparison to the commonly used Charlso
n index for prognostic ability in a HNCA population.
Methods. Proportional hazards methods were applied to head and neck cancer
patients whose treatment included surgery by the Johns Hopkins Otolaryngolo
gy service (n = 388).
Results. The Charlson index and ASA class were modestly correlated (Spearma
n 0.36, p < .001). Compared with patients with ASA class 1 or 2, those with
ASA class 3 or 4 had a two-fold elevated mortality rate (Relative Hazard (
RH) = 2.00, 95% Cl, 1.36-2.89). This association was stronger than observed
for a Charlson index score of 1 or more compared with 0 (RH = 1.59, 95% Cl
, 1.17-2.17). Both the Charlson index and ASA class adjusted RHs displayed
dose-response patterns (p value for trend <.001).
Conclusions. Compared with the Charlson index, the ASA class had comparable
if not greater prognostic ability for mortality in this elderly HNCA popul
ation. (C) 2001 John Wiley & Sons, Inc.