A Comparative Study of SHAPE scoring system over ASA grading system in predicting post operative ICU care in ASA three patients undergoing major surgeries

ASA PS classification was proposed by American Society of Anaesthesiologists (ASA) in 1941, it is the commonly used system throughout the field of anaesthesia to predict the incidence of intra- and postoperative complications in surgical patients, (ASA PS) system is a (6-grade) system from ASA I to ASA VI in evaluating the patients in pre opeerative assessement.

However ASA PS system, which was routinely followed in today’s clinical practice has some limitations over the period of time, namely: Inability to distinguish disorders of different systems; inability to delineate or cumulate risk based upon multiple system involvement; to consider surgical invasiveness, or identify specific anaesthetic risk.

Dr. Mohamed Daabiss suggested the use of Tomoaki and Yoshihisa’s ASA PS 7 grade classification which takes into consideration operative and anaesthetic factors to a certain extent.However, this also seems to be quite subjective, and fails to identify single or multiple systems involvement, extent of surgical invasiveness or specificity of anaesthetic factor.

To overcome the limitations of ASA PS system,a new risk stratification scoring system,Silverman-Holt aggregate preoperative evaluation (SHAPE) was introduced by SILVERMAN & HOLT in the year 2010 which overcomes all above mentioned limitations.

In this study we include 90 participants after informed and written consent , who are undergoing major surgeries in ESIC MEDICAL COLLEGE, KK NAGAR, CHENNAI. We will use both ASA PS scoring system and SHAPE scoring system for evaluating the effectiveness of SHAPE scoring system over ASA grading system in predicting post operative ICU care in ASA 3 pateints undergoing major surgeries.

Through this study we can evaluate the effectiveness of SHAPE scoring system over ASA PS scoring system to overcome the limitations of it, as it takes only the preoperative physical status of patient into consideration which is one of the many factors affecting perioperative outcome and confusion arises in grading the patient when multiple systems are involved as not every system is involved to the same extent , so that we can predict the need of post operative ICU care in ASA 3 patients undergoing major surgeries , also to predict unanticipated post operative ICU care in ASA 2 patients in ESIC MEDICAL COLLEGE, KK NAGAR, CHENNAI, so that it will be a great help to reserve ICU beds for patients who are really in need for it, as we have limited amount of ICU beds.