In:
Acta Anaesthesiologica Scandinavica, Wiley
Abstract:
Multimorbidity is a growing burden in our ageing society and is associated with perioperative morbidity and mortality. Despite several modifications to the ASA physical status classification, multimorbidity as such is still not considered. Thus, the aim of this study was to quantify the burden of comorbidities in perioperative patients and to assess, independent of ASA class, its potential influence on perioperative outcome. Methods In a subpopulation of the prospective ClassIntra® validation study from eight international centres, type and severity of anaesthesia‐relevant comorbidities were additionally extracted from electronic medical records for the current study. Patients from the validation study were of all ages, undergoing any type of in‐hospital surgery and were followed up until 30 days postoperatively to assess perioperative outcomes. Primary endpoint was the number of comorbidities across ASA classes. The associated postoperative length of hospital stay (pLOS) and Comprehensive Complication Index (CCI®) were secondary endpoints. On a scale from 0 (no complication) to 100 (death) the CCI® measures the severity of postoperative morbidity as a weighted sum of all postoperative complications. Results Of 1421 enrolled patients, the mean number of comorbidities significantly increased from 1.5 in ASA I (95% CI, 1.1–1.9) to 10.5 in ASA IV (95% CI, 8.3–12.7) patients. Furthermore, independent of ASA class, postoperative complications measured by the CCI® increased per each comorbidity by 0.81 (95% CI, 0.40–1.23) and so did pLOS (geometric mean ratio, 1.03; 95% CI, 1.01–1.06). Conclusions These data quantify the high prevalence of multimorbidity in the surgical population and show that the number of comorbidities is predictive of negative postoperative outcomes, independent of ASA class.
Type of Medium:
Online Resource
ISSN:
0001-5172
,
1399-6576
Language:
English
Publisher:
Wiley
Publication Date:
2024
detail.hit.zdb_id:
2004319-3