key: cord-0068014-qr5dms6u authors: Ortega Quiroga, Laura Zharick; Castellanos Villabona, María Camila; Navarro Mansilla, María Camila; Domínguez-Alvarado, Gonzalo Andrés title: A commentary on “ASA-ECOG as a combined tool for peri-operative risk stratification in COVID-19 survivors – A step towards optimizing healthcare resource utilization” (Int J Surg 2021, July:106062) date: 2021-09-30 journal: Int J Surg DOI: 10.1016/j.ijsu.2021.106132 sha: 9db1b540379ea9eb6280673534f6ba1a578805d1 doc_id: 68014 cord_uid: qr5dms6u nan . entitled "ASA-ECOG as a combined tool for peri-operative risk stratification in COVID-19 survivors -A step towards optimizing healthcare resource utilization", which discusses the need to provide anesthesiologists with a more solid strategy to stratify perioperative risks, and plan an adequate pre-rehabilitation of patients to reduce intra-or post-operative morbidity and mortality rates. We consider that it is important to add some comments on the need to popularize and replicate the use of ASA -ECOG in Latin American countries, especially in Colombia. As of September 10, 2021, there were a total of 43,816,669 COVID-19 cases recorded in Latin America and the Caribbean. Brazil was in the first place with 20.9 million confirmed cases and Colombia was in the third place with 4,925,000 confirmed cases [2] . The statistics on surgical procedures have not been updated. However, the latest report of the World Bank stated that in Colombia for the year 2015, 27,385 surgical procedures were performed per 100,000 inhabitants. According to the reports of the International Society of Aesthetic Plastic Surgery (ISAPS) for 2017, Colombia ranked as the fourth country worldwide with the largest number of aesthetic procedures [3] . Thus, these figures show that there is a great surgical demand in our country, although without taking into account cardiovascular and oncological procedures. The COVID-19 pandemic results in a high demand of Intensive Care Units (ICU), with hospitals drastically reducing budgets for surgical procedures [4] . Effective management of resources directed to operating rooms has to be introduced. The American College Of Surgeon suggests "the medically necessary, time-sensitive (MeNTS) score system to Ethically and Efficiently Manage Resource scarcity and provider risk". However, this score system has multiple shortcomings and it does not take into account COVID-19 infection [5, 6] . Currently in Colombia, we continue to use the ASA score for perioperative classification. However, this score is not sufficient to allow adequate prediction of perioperative risks since it does not take into account functional deterioration and/or deal with conditions after COVID -19 [1]. In conclusion, it is very important to replicate this score system in pre-operative anesthetic consultation, with the aim of reducing morbidity and mortality rates after surgery. We appreciate the authors for providing with such evidences and consider that more studies should be performed to provide external validation of this score. "Provenance and peer review Commentary, internally reviewed" None. It is not necessary. 1. Name of the registry: Not applicable. 2. Unique Identifying number or registration ID: Not applicable. 3. Hyperlink to your specific registration (must be publicly accessible and will be checked): Not applicable. ?id=2203b04c3a5f486685a15482a0d97a87&extent =-17277700.8881%2C-1043174.5225%2C-1770156.5897%2C6979655.9663% 2C102100 Cantidad de procedimientos quirúrgicos (por cada 100 000 habitantes) -Colombia | Data Impact of the Coronavirus (COVID-19) pandemic on surgical practice -Part 1 ′′ Volver a empezar: cirugía electiva durante la pandemia del SARS-CoV2. Recomendaciones desde la Asociación Colombiana de Cirugía Medically Necessary, Time-Sensitive Procedures: Scoring System to Ethically and Efficiently Manage Resource Scarcity and Provider Risk During the COVID-19 Pandemic All authors equally contributed to the analysis and writing of the manuscript. Dominguez -Alvarado GA, Epidemiólogo, Docente, Universidad Autónoma de Bucaramanga, director Grupo de Innovación e Investigacion Quirúrgica (GIIC). Bucaramanga, Santander, Colombia. Email: Gdominguez@unab.edu.co None.