Key result
ASA classification dominates preoperative cardiovascular assessment with ~98% usage, far outpacing specific cardiac risk scores.
Why the study?
Multiple risk scoring systems exist for preoperatively determining cardiovascular surgery risk, but national-level usage patterns among physicians assessing these patients remained to be determined.
Cross-Sectional (n=125)
Yes
While the ASA Physical Status Classification is almost universally used by anesthesiologists in Turkey before cardiovascular surgery, specific cardiac risk scoring systems like EuroSCORE II are underutilized.
Widespread ASA PSC use with limited cardiac-specific scoring may signal a practice gap; leaves open whether education improves risk stratification in cardiovascular surgery.
Objectives: There are different risk scoring systems (RSSs) for preoperatively determining the risk of cardiovascular surgery. Herein, we aimed to determine which of the current RSSs are used at the national level to assess patients who are planned for cardiovascular surgery. Methods: A survey was conducted electronically or via face-to-face interviews. The number and rate of physicians using RSSs in combination with the American Society of Anesthesiologists (ASA) Physical Status Classification (ASA PSC) were determined. Additionally, the extent to which patients and their relatives were informed about the preoperatively predicted cardiac risk was determined. Results: Of the 139 participating physicians, only 125 were analyzed. The ASA PSC (n=123, 98.4%), EuroSCORE II (n=48, 38.4%), and CARE score (n=23, 18.4%) were the most commonly used scoring systems for determining the risk level. Among the physicians who used the ASA PSC, 67 (53.6%) only used the ASA PSC. The other 56 (44.8%) physicians used one or more RSSs in combination with the ASA PSC. EuroSCORE II (n=48, 38.4%) was commonly used to determine the risk. Only 16 physicians (12.8%) reported using the ASA PSC, EuroSCORE II, and CARE score in combination, (the most frequent triplet combination). Furthermore, 74 physicians (59.2%) informed the patients and their relatives about the preoperative risk.
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Pelin Gürel (2024) conducted a cross-sectional in Preoperative anesthetic assessment for cardiovascular surgery (n=125). Cardiac risk scoring systems was evaluated on Usage rate of ASA Physical Status Classification (ASA PSC). The ASA Physical Status Classification was used by 98.4% of surveyed anesthesiologists for preoperative assessment before cardiovascular surgery, whereas specific cardiac risk scores like EuroSCORE II were used by only 38.4%.
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