American Society of Anaesthesiologists score (ASA) to predict the morbidity and mortality of patients after emergency laparotomy: A prospective analysis

Background: Emergency laparotomy is one of the operations which is done commonly and performed in all age groups. We have conducted this prospective study to evaluate the effectiveness of ASA grading as an outcome predictor in emergency laparotomy. Methods: We conducted this prospective observational study in the Department of Anaesthesiology, Critical Care, Pain & Palliative Medicine, Dr Sushila Tiwari Government Hospital, Haldwani over one year. Data was collected of patients along with ASA grading and all necessary laboratory investigations. The primary outcome measured was significant complications and mortality within 4 weeks. Results: Out of 274 total patients,181(66.4%) were males. Majority of the patients in study 119(43.4%) were of ASA II E, 76(27.7%) were ASA III E, 54(19.7%) were ASA I E and 25(9.1%) were ASA IV E. Postoperative complications were seen in 119(43.4%) out of total 274 patients. Mortality after emergency laparotomy was 23%(63 died out of 274). ASA IV E had maximum mortality where 20(80%) died out of 25, followed by ASA III E where 32(42.1%) died out of 76. Patients of ASA IV E and ASA III E group developed maximum postoperative complications seen in 23(92%) out of 25, 64 (84.2%) out of 76 respectively. Conclusion: Maximum mortality and postoperative complications were seen in ASA 1V E followed by ASA III E followed by ASA II E and ASA I E. Thus, ASA classification have an association with postoperative mortality and complications.