Overview of Preoperative Risk Analysis: American Society of Anesthesiology Physical Status Classification and the Surgical Risk Calculator

AANA J. 2022 Dec;90(6):469-475.

Abstract

The certified registered nurse anesthetist has a vital role and critical position to provide safe and effective anesthesia and to speak on behalf of the patient when they cannot speak for themselves. Paramount to this process is analyzing risk factors related to the patient's physical status, the specific surgical procedure, and the method of anesthesia delivery. The American Society of Anesthesiology Physical Status Classification is a foundation in preoperative patient assessment. This preoperative assessment tool is used for assessing patient's functional reserve and risk for anesthesia. The American College of Surgeons National Surgical Quality Improvement Program developed the Surgical Risk Calculator. This preoperative assessment tool uses 21 preoperative risk factors to predict 13 perioperative complications and is proving to be a reliable indicator for predicting patient risk. Anesthetic techniques such as multimodal analgesia and enhanced recovery after surgery have demonstrated a significant impact on patient outcomes. There are potential improvements and opportunities for anesthesia providers to collaborate and improve patient risk analysis.

Keywords: CRNA; preoperative assessment; risk analysis.

MeSH terms

  • Anesthesia* / adverse effects
  • Anesthesiology*
  • Humans
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Quality Improvement
  • Risk Assessment / methods
  • United States