Co-relation of ASA-PS with post operative complications and morbidity in hysterectomy patients

In: International Journal of Research in Medical Sciences · 2018 · vol. 6(9) , pp. 2964 · doi:10.18203/2320-6012.ijrms20183447 · W2887757321
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This retrospective study of 100 hysterectomy patients, including those with adenomyosis, found that higher ASA-PS grades strongly correlate with increased post-operative medical complications such as infection and thrombosis.

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This retrospective study evaluated the correlation between American Society of Anesthesiologists Physical Status (ASA-PS) grades and postoperative complications in 100 women undergoing hysterectomy. The patient cohort included individuals with various indications, such as fibroids, menorrhagia, adenomyosis, and uterovaginal prolapse, with most patients classified as ASA-PS grade 1 or 2. The researchers found that higher ASA-PS grades were significantly associated with an increased risk of medical complications, including urinary tract infections, deep vein thrombosis, and pneumonia, establishing the classification as a valuable prognostic metric. Relevance to endometriosis: listed as one indication for hysterectomy alongside adenomyosis and fibroids, though the paper's main focus is perioperative risk stratification rather than the pathophysiology of these conditions.

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Abstract

Background: Today, ASA grading is done for any surgical case performed under anesthesia. ASA PS is significantly associated with post-operative morbidity and mortality. For gynecologists, hysterectomy is the most common operation performed by gynecologists, next to caesarean section. The primary focus of this study was to review the ASA-PS of hysterectomy patients.Methods: This retrospective study was performed in the department of Anesthesiology, in collaboration with Department of Obstetrics and gynecology. All women who underwent hysterectomy were included in this study.Results: In this study, out of 100 patients, clinical indication was fibroid in 45 (45%) patients, menorrhagia in 15 (15%) patients, adenomyosis in 25 (25%) patients, uterovaginal prolapse in 5 (5%) patients, endometrial polyp in 5 (5%) patients and ovarian tumor in 5 (5%) patients. ASA-PS grade 1 was seen in 65 (65%) of patients, 25 (25%) of patients had ASA-PS grade 2, 10 (10%) of patients had ASA-PS grade 3 while none of the patients had ASA-PS grade 4 and 5. 4 (4%) patients had urinary tract infection, 2 (2%) patients had deep vein thrombosis, 1 (1%) patient had myocardial infarction and 1 (1%) patients had pneumonia. 25 (25%) patients were obese, 24 (24%) patients had diabetes, 20 (20%) patients had hypertension requiring treatment and 6 (6%) patients had wound infection.Conclusions: ASA PS has strong, independent association with post-operative medical complications. This along with its simplicity, makes it a valuable prognostic metric.
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Background

Today, ASA grading is done for any surgical case performed under anesthesia. ASA PS is significantly associated with post-operative morbidity and mortality. For gynecologists, hysterectomy is the most common operation performed by gynecologists, next to caesarean section. The primary focus of this study was to review the ASA-PS of hysterectomy patients.

Methods

This retrospective study was performed in the department of Anesthesiology, in collaboration with Department of Obstetrics and gynecology. All women who underwent hysterectomy were included in this study.

Results

In this study, out of 100 patients, clinical indication was fibroid in 45 (45%) patients, menorrhagia in 15 (15%) patients, adenomyosis in 25 (25%) patients, uterovaginal prolapse in 5 (5%) patients, endometrial polyp in 5 (5%) patients and ovarian tumor in 5 (5%) patients. ASA-PS grade 1 was seen in 65 (65%) of patients, 25 (25%) of patients had ASA-PS grade 2, 10 (10%) of patients had ASA-PS grade 3 while none of the patients had ASA-PS grade 4 and 5. 4 (4%) patients had urinary tract infection, 2 (2%) patients had deep vein thrombosis, 1 (1%) patient had myocardial infarction and 1 (1%) patients had pneumonia. 25 (25%) patients were obese, 24 (24%) patients had diabetes, 20 (20%) patients had hypertension requiring treatment and 6 (6%) patients had wound infection.

Conclusions

ASA PS has strong, independent association with post-operative medical complications. This along with its simplicity, makes it a valuable prognostic metric. Metrics

References

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