Is there any difference in American Society of Anesthesiologists physical status score between nonagenarian and septuagenarian patients?

Lee, Guie Yong; Kim, Youn Jin

Abstract

BACKGROUND
As the life expectancy increases, extreme old age is not a contraindication to surgery. Limited information is available regarding preoperative evaluation for very old patients in Korea. We hypothesized that the American Society of Anesthesiologists physical status (ASA PS) score would differ between nonagenarian and septuagenarian patients in Korea.
METHODS
The medical records of 100 nonagenarian (90s group) and septuagenarian (70s group) patients who had received elective surgery under general or regional anesthesia were reviewed to investigate their nutritional status, coexisting diseases, surgical procedure related cardiac risk, and ASA PS before surgery.
RESULTS
The body mass index, hemoglobin, arterial oxygen partial pressure and albumin levels were significantly lower in the 90s group than in the 70s group. The age-adjusted Charlson Comorbidity Index was significantly higher in the 90s group than in the 70s group. The intermediate cardiac risk associated with surgical procedures was significantly higher in the 90s group than in the 70s group. There was no significant difference in the ASA PS class between the 90s group and the 70s group.
CONCLUSIONS
The nonagenarian patients did not present a significant difference from the septuagenarian patients in ASA PS classification. However, the comorbidity index scores and cardiac risk related to surgical procedures were higher in the 90s group than in the 70s group. Thus, in the preoperative evaluation of very old patients, a category assessing their physiologic reserve should be added.