The Comparison of ASA, SORT, CCI and CACI Indexes to Predict Postoperative Intensive Care Requirement in Patients with Gastrointestinal Malignancy Surgery


  • Mustafa Kılıç
  • Elif Bombacı
  • Banu Çevik

Received Date: 18.03.2018 Accepted Date: 06.06.2018 Med J Bakirkoy 2019;15(2):142-149


In this retrospective study, it has been aimed to investigate the effectiveness of Charlson Comorbidity Index (CCI), Charlson Age-added Comorbidity Index (CACI), Surgical Risk Result Tool (SORT) and American Society of Anesthesiologists, (ASA) classification and indexes to predict the intensive care (IC) needs of the patients who will have gastrointestinal system tumor operations.


In this study, data of the patients who had oncologic gastrointestinal system operation between 01 April 2015 and 31 May 2017 have been scanned retrospectively. In the direction of these assessments 4 groups have been created as; Group 1) Patients in whom intensive care necessity was foreseen in preoperative evaluation and needed intensive care after the surgery, Group 2) Patients in whom postoperative intensive care necessity was foreseen but they have been transferred to the surgical department without the need of postoperative intensive care follow up, Group 3) Patients in whom intensive care need was not foreseen but they have been followed up intensive care unit after surgery, and Group 4) Patients in whom intensive care need was not foreseen and they have been transferred to the surgical department after the operation. Each patient’s ASA, SORT score, CCI, CACI indexes were calculated and recorded. Furthermore the patients’ age, gender, type of the surgery, comorbidities etc. were recorded. For the statistical analysis IBM SPSS Statistics version 22.0 program was used. By using ROC graph, the effects of SORT, CACI, and CCI indexes were analyzed to anticipate if the patients will need intensive care following surgery.


The prevalence of advanced age, multiple comorbid disease and some operations (esophageal or pancreatic operations), which were predicted as intensive care indications in preoperative evaluation, were significantly higher in patients requiring intensive care after surgery. In evaluation of sensitivity and originality, the area that remains under the ROC graph was SORT: 0,746 CACI: 0,795 and CCI: 0,706.


While CACI gave the best rates in determination of the patients’ need for the intensive care, it was observed that CCI index had the weakest precision among these 4 methods. It has been concluded that the efficacy SORT, which includes all the determinants of the patient’s age, ASA physical condition, comorbid diseases and the characteristics of the surgery, was not found superior to other indexes, to determine the need for intensive care in elective patients.

Keywords: Intensive care ındication, Charlson Comorbidity Index, Charlson Age-added Comorbidity Index, surgical risk result tool, ASA physical status

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