Table 1: American Society of Anesthesiologists (ASA) physical status classification system [16].

ASA Class

Definition

Adult 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, 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, 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, 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 bleed with mass effect, 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

 

Abbreviations: BMI: Body Mass Index; DM: Diabetes Mellitus; HTN: Hypertension; COPD: Chronic Obstructive Pulmonary Diseases; ESRD: End-Stage Renal Disease; PCA: Post Conceptual Age; MI: Myocardial Infarction; CVA: Cerebrovascular Accident; TIA: Transient Ischemic Attach; CAR: Coronary Artery Disease; DIC: Disseminated Intravascular Coagulation; ARD: Advanced Renal Disease