Document Detail


Prediction of rate and severity of adverse perioperative outcomes: "normal accidents" revisited.
MedLine Citation:
PMID:  22238038     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The American Society of Anesthesiologists Physical Status classification system has been shown to predict the frequency of perioperative morbidity and mortality despite known subjectivity, inconsistent application, and exclusion of many perioperative confounding variables. The authors examined the relationship between the American Society of Anesthesiologists Physical Status and both the frequency and the severity of adverse events over a 10-year period in an academic anesthesiology practice. The American Society of Anesthesiologists Physical Status is predictive of not only the frequency of adverse perioperative events, but also the severity of adverse events. These nonlinear mathematical relationships can provide meaningful information on performance and risk. Calculated odds ratios allow discussion about individualized anesthesia risks based on the American Society of Anesthesiologists Physical Status because the added complexity of the surgical or diagnostic procedure, and other perioperative confounding variables, is indirectly factored into the Physical Status classification. The ability of the American Society of Anesthesiologists Physical Status to predict adverse outcome frequency and severity in a nonlinear relationship can be fully explained by applying the Normal Accident Theory, a well-known theory of system failure that relates the interactive complexity of system components to the frequency and the severity of system failures or adverse events. Mt Sinai J Med 79:46-55, 2012. © 2012 Mount Sinai School of Medicine.
Authors:
Albert J Saubermann; Robert S Lagasse
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Mount Sinai journal of medicine, New York     Volume:  79     ISSN:  1931-7581     ISO Abbreviation:  Mt. Sinai J. Med.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0241032     Medline TA:  Mt Sinai J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-55     Citation Subset:  IM    
Copyright Information:
© 2012 Mount Sinai School of Medicine.
Affiliation:
Albert Einstein College of Medicine, Bronx, NY.
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