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May 22, 1996

The American Society of Anesthesiologists Physical Status Score and Risk of Perioperative Infection-Reply

Author Affiliations

Children's Hospital Boston, Mass

JAMA. 1996;275(20):1544. doi:10.1001/jama.1996.03530440022022

In Reply.  —We thank Dr Rozner for his comments but disagree with his claim that the ASA score "has never been correlated with any risk for infection." By using data from more than 84 000 operations performed at 44 US hospitals participating in the National Nosocomial Infections Surveillance (NNIS) System, the Centers for Disease Control and Prevention developed a risk index that is a significantly better predictor of a surgical patient's risk of acquiring a surgical wound infection (SWI) than the traditional wound classification system of categorizing wounds as clean, clean-contaminated, contaminated, or dirty-infected.1 For each surgical procedure a risk index score ranging from 0 to 3 was used to represent the number of risk factors present among the following: (1) whether the patient had an ASA preoperative assessment score of 3, 4, or 5; (2) an operation classified as contaminated or dirty-infected; and (3) an operation lasting over