Table 1 American Society of Anesthesiologists physical classification system (Durham et al. 2006)
From: Impact of ASA score misclassification on NSQIP predicted mortality: a retrospective analysis
ASA physical status classification | Definition | Examples, including, but not limited to |
|---|---|---|
ASA I | A normal healthy patient | Healthy, non-smoking, no or minimal alcohol use |
ASA II | A patient with mild systemic disease | Mild diseases only without substantive functional limitations. Examples include (but not limited to) current smoker, social alcohol drinker, pregnancy, obesity (30 < BMI < 40), well-controlled DM/HTN, and mild lung disease |
ASA III | A patient with severe systemic disease | Substantive functional limitations: one or more moderate to severe diseases. Examples include (but not limited to) poorly controlled DM or HTN, COPD, morbid obesity (BMI ≥ 40), active hepatitis, alcohol dependence or abuse, implanted pacemaker, moderate reduction of ejection fraction, ESRD undergoing regularly scheduled dialysis, premature infant PCA < 60 weeks, and history (> 3 months) of MI, CVA, TIA, or CAD/stents |
ASA IV | A patient with severe systemic disease that is a constant threat to life | Examples include (but not limited to) recent (< 3 months) MI, CVA, TIA, or CAD/stents, ongoing cardiac ischemia or severe valve dysfunction, severe reduction of ejection fraction, sepsis, DIC, and ARD or ESRD not undergoing regularly scheduled dialysis |
ASA V | A moribund patient who is not expected to survive without the operation | Examples include (but not limited to) ruptured abdominal/thoracic aneurysm, massive trauma, intracranial bleeding with mass effect, and ischemic bowel in the face of significant cardiac pathology or multiple organ/system dysfunction |
ASA VI | A declared brain-dead patient whose organs are being removed for donor purposes |