Philippine E-Journals

Evaluating the diagnostic accuracy of hypertrophic submucosal nerve diameter measurement in the diagnosis of Hirschsprung disease in rectal suction biopsies in the Philippine Children’s Medical Center

Maria Erica U. Hitosis | Farrah Kristine F Santiago | Joana Paula S. Artaiz-pido

Discipline: medicine by specialism

 

Abstract:

OBJECTIVE: To compare the performance of the following scoring systems, the ASA PS and the NARCO – SS in terms of predicting perioperative outcomes in pediatric patients who underwent anesthesia at the Philippine Children's Medical Center. MATERIALS AND METHODS: This is a retrospective cohort chart review study; ASA-PS and NARCO-SS scores were assigned to 361 children, and predefined perioperative adverse events and escalation of care were recorded. Spearman’s correlation was used to determine the relationship between outcomes and scores. The predictive performance of ASA-PS and NARCO-SS was evaluated by area under the ROC curve. RESULTS: NARCO-SS and ASA-PS scores had significant Spearman’s correlation coefficients with perioperative outcomes. Individual categories of NARCO demonstrate a weak correlation with the outcomes of interest. Both the ASA and NARCO-SS scoring systems were able to correctly identify patients requiring escalation of care and those who experienced adverse events, particularly at higher score levels. The NARCO-SS showed greater discrimination than the ASA-PS for escalation of care (AUC-ROC 0.8622 vs 0.8273, Chi2 = 4.02, p-value = 0.0450) and for adverse events (AUC- ROC 0.8185 vs 0.0.792, Chi2 = 1.95, p-value =0.1623). CONCLUSION: We validated the use of NARCO-SS as a risk stratification tool with better discriminating ability in predicting for escalation of care compared to ASA-PS. Further studies are suggested to assess the interrater reliability of