Inter-rater variability for the American Society of Anesthesiologists classification in patients undergoing hepato-pancreato-biliary surgery (MILESTONE-2): international survey among surgeons and anaesthesiologists

作者：Simone Augustinus, Jasper P. Sijberden, Matthanja Bieze, Vandana Agarwal, Luca Aldrighetti, Adnan Alseidi, Francisco Carlos Bonofiglio, Kevin C. Conlon, Katia Donadello, Joris I. Erdmann, Cristina R. Ferrone, Michael Guertin, Ronald L. Harter, Maria Elena Franceschetti, Giuseppe Fusai, Bas Groot Koerkamp, Thilo Hackert, Jin‐Young Jang, Thomas Kander, Tobias Keck, Dominik Krzanicki, Ho‐Jin Lee, Keith E. Lewis, Giuseppe Natalini, Carla Nau, Timothy M. Pawlik, Henry A. Pitt, Rafaella Reineke, Roberto Salvia, Eduardo de Santibáñes, Shailesh V. Shrikhande, Martin H. Smith, Attila Szíjártó, Bobby Tingstedt, Alice C. Wei, John A. Windsor, Mohammad Abu Hilal, Manuel Pardo, Markus W. Hollmann, Marc G. Besselink · 发表于：BJS Open · 年份：2024 · DOI：10.1093/bjsopen/zrae162 · 被引用次数：7 · 研究领域：Pancreatic and Hepatic Oncology Research、Hepatocellular Carcinoma Treatment and Prognosis、Gallbladder and Bile Duct Disorders

BACKGROUND: Patients undergoing hepato-pancreato-biliary surgery are typically preoperatively assessed using the American Society of Anesthesiologists (ASA) classification, which is also used for case-mix adjustment when comparing centre outcomes. Studies determining the inter-rater variability of the ASA classification within hepato-pancreato-biliary surgery are currently lacking. METHODS: An international survey was collected and a case-vignette study was performed (November 2022-April 2023) regarding the ASA classification in patients undergoing hepato-pancreato-biliary surgery among anaesthesiologists and surgeons from (inter)national societies. The survey consisted of 23 questions and eight case-vignettes. Primary analysis included descriptive statistics and the inter-rater variability was calculated using Light's Kappa. RESULTS: Overall, 1283 participants from 55 countries responded: 1073 (84%) anaesthesiologists and 210 (16%) surgeons. The ASA classification was commonly used, both clinically 1003/1283 (78%) and for research 728/762 (96%). The majority of respondents (n = 1019, 79%) declared that ASA score impacted their perioperative strategy. There inter-rater variability was fair-moderate (Kappa 0.26-0.42) in all case-vignettes. Inter-rater variability differed within and among geographic regions for each case. Over 80% (n = 1138) of respondents stated that they would take the underlying disease (for example cancer) into account, but this changed the preferred ASA s...