Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 14, Number 4, August 2021, pages 214-219

The Role of Clinical Characteristics in Stratifying Sedation Risk: A Cohort Study

**Table 1.** Demographics and ASA Classification for All Patients
	MAC, n (%)	Sedation, n (%)	P value (Bonferroni corrected)
MAC: monitored anesthesia care; ASA: American Society of Anesthesiologists; PolySUD: polysubstance use disorder.
Gender
Male	674 (66.2)	390 (33.8)	P < 0.001
Female	506 (52.2)	463 (47.8)
Age
Age < 18	47 (88.7)	6 (11.3)	P < 0.001
Age 18 - 40	145 (60.4)	77 (39.6)
Age 41 - 60	459 (58.8)	321 (41.2)
Age 60+	529 (54.1)	449 (45.9)
ASA
ASA I	198 (77.0)	69 (23.0)	P < 0.001
ASA II	525 (38.9)	824 (61.1)
ASA III	128 (33.6)	253 (66.4)
ASA IV	2 (5.6)	34 (94.4)
Alcohol abuse	354 (60.2)	234 (39.8)	0.10
Opioid abuse	178 (62.9)	105 (37.1)	0.04
PolySUD	203 (73.6)	73 (26.4)	P < 0.001
Psychiatric diagnosis	815 (75.1)	270 (24.9)	P < 0.001

Table 1. Demographics and ASA Classification for All Patients

MAC, n (%)

Sedation, n (%)

P value (Bonferroni corrected)

N = 1,180

N = 853

MAC: monitored anesthesia care; ASA: American Society of Anesthesiologists; PolySUD: polysubstance use disorder.

Gender

Male

674 (66.2)

390 (33.8)

P < 0.001

Female

506 (52.2)

463 (47.8)

Age

Age < 18

47 (88.7)

6 (11.3)

P < 0.001

Age 18 - 40

145 (60.4)

77 (39.6)

Age 41 - 60

459 (58.8)

321 (41.2)

Age 60+

529 (54.1)

449 (45.9)

ASA

ASA I

198 (77.0)

69 (23.0)

P < 0.001

ASA II

525 (38.9)

824 (61.1)

ASA III

128 (33.6)

253 (66.4)

ASA IV

2 (5.6)

34 (94.4)

Alcohol abuse

354 (60.2)

234 (39.8)

0.10

Opioid abuse

178 (62.9)

105 (37.1)

0.04

PolySUD

203 (73.6)

73 (26.4)

P < 0.001

Psychiatric diagnosis

815 (75.1)

270 (24.9)

P < 0.001

**Table 2.** Multivariate Regression of Anesthetic Choice as a Function of the Identified Clinical Characteristics
	Odds ratio (95% CI)	P values
CI: confidence interval; PolySUD: polysubstance use disorder; ASA: American Society of Anesthesiologists.
Age	0.984 (0.978 - 0.990)	P < 0.001
Sex	0.644 (0.524 - 0.790)	P < 0.001
Alcohol abuse	1.29 (1.02 - 1.65)	0.04
Opioid abuse	0.778 (0.568 - 1.06)	0.12
PolySUD	1.54 (1.11 - 2.13)	0.01
Psychiatric diagnosis	4.66 (3.67 - 5.90)	P < 0.001
ASA status	1.03 (0.821 - 1.28)	0.82

Table 2. Multivariate Regression of Anesthetic Choice as a Function of the Identified Clinical Characteristics

Odds ratio (95% CI)

P values

CI: confidence interval; PolySUD: polysubstance use disorder; ASA: American Society of Anesthesiologists.

Age

0.984 (0.978 - 0.990)

P < 0.001

Sex

0.644 (0.524 - 0.790)

P < 0.001

Alcohol abuse

1.29 (1.02 - 1.65)

0.04

Opioid abuse

0.778 (0.568 - 1.06)

0.12

PolySUD

1.54 (1.11 - 2.13)

0.01

Psychiatric diagnosis

4.66 (3.67 - 5.90)

P < 0.001

ASA status

1.03 (0.821 - 1.28)

0.82

**Table 3.** Substance Abuse Rates and Psychiatric Comorbidity for ASA II Patients
	Conscious sedation, n (%)	MAC, n (%)	P value (Bonferroni corrected)
ASA: American Society of Anesthesiologists; MAC: monitored anesthesia care; PolySUD: polysubstance use disorder.
Alcohol abuse	104 (19.8)	172 (20.9)	0.05
Opioid abuse	25 (4.8)	92 (11.2)	P < 0.001
PolySUD	19 (3.6)	100 (12.1)	P < 0.001
Psychiatric diagnosis	140 (26.7)	528 (64.1)	P < 0.001

Table 3. Substance Abuse Rates and Psychiatric Comorbidity for ASA II Patients

Conscious sedation, n (%)

MAC, n (%)

P value (Bonferroni corrected)

N = 525

N = 824

ASA: American Society of Anesthesiologists; MAC: monitored anesthesia care; PolySUD: polysubstance use disorder.

Alcohol abuse

104 (19.8)

172 (20.9)

0.05

Opioid abuse

25 (4.8)

92 (11.2)

P < 0.001

PolySUD

19 (3.6)

100 (12.1)

P < 0.001

Psychiatric diagnosis

140 (26.7)

528 (64.1)

P < 0.001

**Table 4.** Subset Analysis of ASA II Patients Who Received MAC Only Versus Those Who Received MAC After Previously Failing Moderate Sedation (MS)
	MAC, post-MS failure, n (%)	MAC only, n (%)	P value (Bonferroni corrected)
ASA: American Society of Anesthesiologists; MAC: monitored anesthesia care; PolySUD: polysubstance use disorder.
Alcohol abuse	178 (27.4)	24 (13.7)	P < 0.001
Opioid abuse	75 (11.6)	17 (9.7)	0.004
PolySUD	72 (11.1)	28 (16.0)	P < 0.001
Psychiatric diagnosis	423 (65.2)	105 (60.0)	P < 0.001

Table 4. Subset Analysis of ASA II Patients Who Received MAC Only Versus Those Who Received MAC After Previously Failing Moderate Sedation (MS)

MAC, post-MS failure, n (%)

MAC only, n (%)

P value (Bonferroni corrected)

N = 649

N = 175

ASA: American Society of Anesthesiologists; MAC: monitored anesthesia care; PolySUD: polysubstance use disorder.

Alcohol abuse

178 (27.4)

24 (13.7)

P < 0.001

Opioid abuse

75 (11.6)

17 (9.7)

0.004

PolySUD

72 (11.1)

28 (16.0)

P < 0.001

Psychiatric diagnosis

423 (65.2)

105 (60.0)

P < 0.001