A study published in The Spine Journal examines how the American Society of Anesthesiology classification system affects 30-day morbidity after single-level anterior cervical discectomy and fusion.
The researchers gathered data on 6,148 patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent spinal fusion from 2011 to 2013. The researchers found:
1. Patients with an ASA greater than two reported higher incidence of comorbidities as well as postoperative complications that included:
• Pneumonia
• Unplanned intubation
• Ventilator-dependent for more than 48 hours
• CVA/stroke
• Catastrophic outcomes
• Airway complications
2. The researchers conducted a multivariable analysis with the propensity-score matched dataset and found there was an association between 30-day outcomes and ASA 3 or higher patients.
3. There wasn't an association between patients who were ASA 3 or higher and greater risk of complications that included pneumonia, unplanned intubation and airway complications.
4. The researchers concluded the "ASA classification allows simple assessment of patients' physiological status" but the overall perioperative risk factors should be considered to optimize ACDF outcomes.