ASA Physical Status Score as a Predictive Tool of Mortality in Emergency Postoperative Abdominal Injuries in the ICU

Abstract

Background: The factors affecting the pattern and outcome of management of postoperative abdominal injuries in the intensive care unit of University of Uyo Teaching Hospital has never been investigated. This is especially important against a backdrop of limited resources in our intensive care unit. Aim: This study seeks to determine the pattern and outcome of ICU management of postoperative abdominal injuries, and whether the American Society of Anesthesiologists physical status (ASA-PS) score is of any prognostic value with regards to outcome in this patient population. Patients and Methods: This was a retrospective study of all postoperative patients admitted into the ICU on account of abdominal injuries (blunt and penetrating), between April 2006 and November 2014. Data for each patient was obtained from the ward and ICU records. Data collected were Age, Sex, Mechanism of Abdominal injury, ASA-PS score, ICU Length of Stay and Outcome of Management. Prolonged ICU length of stay was taken as >72 hours. Results: Thirty-six patients with either blunt or penetrating abdominal injuries were studied. Thirty (83.3%) of these patients were males while six (16.7%) were females; giving a male to female ratio of 5:1. A majority of patients (36.1%) were between 25 and 39 years. There were more blunt 22 (61.1%), than penetrating 14 (38.9%), abdominal injuries. Thirteen (36.1%) were ASA IIIE, 19 (52.8%) were ASA IVE and 4 (11.1%) were ASA VE. The ASA-PS score of patients had no significant association with the type of abdominal injury (P = 0.722). There was no significant association between the ASA-PS score of patients, and outcome of management, with the length of patient stay in ICU. Outcome of management was significantly associated with the ASA status of patient (P = 0.001). Conclusion: The ASA-PS of emergency post laparotomy patients admitted to the ICU is possibly a viable tool for prognostication of outcome of management.