Table 4 Reasons for ASA misclassification in the study population
From: Impact of ASA score misclassification on NSQIP predicted mortality: a retrospective analysis
2014 mortalities | |||
Patient | Charted ASA | Recalculated ASA | Reason for change |
1 | 4 | 5 | Ruptured abdominal aortic aneurysm with intraoperative cardiac arrest |
2 | 3E | 5E | Superior mesenteric artery occlusion with bowel ischemia |
3 | Not recorded | 5 | Perforated colon with sepsis. Moribund |
4 | 4 | 3 | Reviewer used subsequent cases after complications instead of index case |
5 | 4 | 3 | Several severe systemic comorbidities (poorly controlled diabetes, chronic obstructive pulmonary disease, asthma), but none were a constant threat to life |
6 | 3 | 4 | Active congestive heart failure |
2014 all cases sample | |||
Patient | Charted ASA | Recalculated ASA | Reason for change |
1 | 3 | 2 | Controlled hypertension and asthma, otherwise healthy. Localized Hurthle cell cancer |
2 | 3 | 4 | Stroke within 3 months |
3 | 3 | 4 | Myocardial infarction within 3 months with 14% left ventricular ejection fraction on echocardiogram |
4 | 3E | 4E | Perforated small bowel with sepsis |
5 | 3E | 2E | Infected thigh hematoma, but not septic. Remote history of supraventricular tachycardia, but otherwise healthy and not on medications |
6 | 3E | 4E | Perforated viscus with sepsis |
7 | 3E | 4E | Bowel necrosis present on colonoscopy prior to operation |
2014 emergency cases sample | |||
Patient | Charted ASA | Recalculated ASA | Reason for change |
1 | 3E | 4E | Perforated viscus |
2 | 3E | 5E | Ruptured abdominal aortic aneurysm |
3 | 3E | 4E | Perforated diverticulitis |
4 | 3E | 4E | Perforated small bowel with sepsis |
5 | 3E | 4E | Ongoing crescendo transient ischemic attacks |
6 | 3E | 2E | Appendicitis, not septic and no major medical problems |