Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The influence of obesity on anesthetic risk remains controversial, and obesity has only recently been specifically identified as a criterion by which a patient can be given a higher American Society of Anesthesiologists-physical status (ASA-PS) score. Nevertheless, we hypothesized that clinicians had assigned obese patients a greater ASA-PS score before obesity became an "official" criterion in 2015. ⋯ These findings suggest a consistent and temporally stable practice of up-coding obese patients despite this lack of explicit guidance. The ASA House of Delegates' recent decision to specifically mention obesity reinforces long-existing practices regarding ASA-PS coding and will likely not degrade the validity of data sets collected before the change.
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The Multicenter Study of Perioperative Ischemia (McSPI) AFRisk index predicts postoperative atrial fibrillation (POAF) after cardiac surgery, but requires pre-, intra-, and postoperative data. Other more abbreviated risk indices exist, but there is no consensus on which risk index is optimal. We compared the discriminatory capacity of the McSPI AFRisk index with three indices containing only preoperative data (the CHA2DS2Vasc score, POAF score, and Kolek clinical risk prediction model), hypothesizing that the McSPI AFRisk index would have superior predictive capacity. ⋯ The McSPI AFRisk index showed superior ability to predict POAF after cardiac surgery compared with three other indices. When clinicians and investigators wish to measure the risk of POAF after cardiac surgery, they should consider using the McSPI AFRisk index.