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Classification system identifies patients at risk for complications from abdominal contouring
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The American Society of Anesthesiologists classification system can be used to rapidly screen patients before abdominal contouring to predict significant complications, according to study results published in Plastic and Reconstructive Surgery.
The classification system includes five class scores (I, II, III, IV and V) that range from a normal healthy patient, through patients with increasing severity of systemic diseases, to a moribund patient who is not expected to survive 24 hours without operation.
Researchers obtained medical records from the National Surgical Quality Improvement Program of 3,637 patients who underwent abdominal contouring between 2007 and 2012. The patients were categorized using the system and their records were reviewed for minor wound complication, medical complication and major surgical complication within the 30-day postoperative period.
Mean ages of patients in classes I, II, III and IV were 39.3, 46.1, 53.8 and 54.5 years, respectively. There were no class V patients. Age was significantly associated with a patient’s class score (P < .001).
The majority of patients had a preoperative class score of II (n = 2,151) or III (n = 850). The remaining patients were in class I (n = 532) or class IV (n = 104). The most common complications were superficial surgical-site infection (n = 177), bleeding requiring transfusion (n = 167) and return to the operating room (n = 154). Overall mortality rate was 0.2%, and included four patients from class III and one from class IV.
The researchers found that BMI, hypertension and an increased class rating were all significantly associated with developing any complication (P < .001). Additionally, there was a trend in increased minor wound complications with increased class (1.5% in class I, 4.7% in class II, 10.8% in class III and 12.5% in class IV). – by Talitha Bennett
Disclosure: The researchers report no relevant financial disclosures.
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