A Descriptive Study on Assessment of the Preoperative Health Status Based on ASA PS versus ABCK

Abstract

Introduction: The ASA score presents the disadvantage of being subjective and its inter-individual concordance rate is criticized by several authors. This study aims at assessing the concordance between ABCK score and ASA score.

Methods: It is a descriptive study conducted from 1st December 2013 to 30th August 2014 in Three hospitals of Kinshasa city: Hôpital de l’amitié sino- congolaise, Hôpital Saint Joseph and Hôpital Marie Biamba Mutombo. All patients admitted for pre-anaesthesia consultation during the period of the study were assessed using ASA score and ABCK score. Were excluded from the study all pregnant women and children.
Informed consent was obtained from all participants. The conformity of the new score with the ASA score was assessed using the kappa of Cohen test.

Results: 768 patients out of them 449 women and 319 men were examined. The sex ratio was 1.4 in favour of women. The average age was 39.4 ±
16.8 years. Low blood pressure and anaemia were the main complications during and post surgery operations and were mostly found in stages 3 and 4 for the 2 scores.
Blood transfusion was frequent in stages 3 and 4 for the 2 scores. Mortality tends to increase with the patient’ stage in the 2 groups (ASA: X2 = 25.98; p< 0.001 and ABCK: X2 = 29.70; p < 0.001). The risk of death was not related to the score used (p = 0.31 as per Fisher for class 3 and X2 = 0.52; p = 0.24 for class 4). And, there was an excellent concordance with a Kappa at 0.86 between ABCK and ASA (p < 0.001).

Conclusion: Even if there is a correlation between ABCK and ASA, it would be very interesting to do a larger study with patients from obstetrics and paediatric surgery who were not included in this study for the goal of generalising the outcomes of this new score.