Anesthesia for Internists-Table 9. Current Definitions of ASA-Approved Examples (PDF)

Table 9. Current Definitions of ASA-Approved Examples (PDF)

Pdf Summary

The American Society of Anesthesiologists (ASA) Physical Status (PS) Classification System categorizes patients based on their preoperative health status to assess anesthesia risk. The classifications range from ASA I to ASA VI:<br /><br />- ASA I: A normal healthy patient with no systemic disease, typically non-smoking and minimal alcohol use.<br />- ASA II: A patient with mild systemic disease without significant functional limitations, including smokers, social drinkers, pregnancy, obesity (BMI 30-40), well-controlled diabetes or hypertension, and mild lung disease.<br />- ASA III: A patient with severe systemic disease causing substantive functional limitations. Examples include poorly controlled diabetes or hypertension, COPD, morbid obesity (BMI 40+), active hepatitis, alcohol dependence, implanted pacemaker, moderate cardiac dysfunction, end-stage renal disease (ESRD) on dialysis, or recent history (within 3 months) of myocardial infarction (MI), cerebrovascular accident (CVA), transient ischemic attack (TIA), or coronary artery disease (CAD) with stents.<br />- ASA IV: A patient with severe systemic disease that poses a constant life threat. This includes recent (within 3 months) MI, CVA, TIA, CAD/stents, ongoing cardiac ischemia, severe valve dysfunction, severe cardiac output reduction, sepsis, disseminated intravascular coagulation (DIC), acute respiratory distress (ARD), or ESRD not on dialysis.<br />- ASA V: A moribund patient not expected to survive without surgery, such as those with ruptured aneurysm, massive trauma, intracranial hemorrhage with mass effect, or ischemic bowel combined with significant cardiac or multi-organ dysfunction.<br />- ASA VI: A brain-dead patient whose organs are being harvested for donation.<br /><br />An “E” suffix denotes emergency surgery, where delays increase risk to life or limb. Notably, pregnancy is classified as ASA II due to significant physiological changes despite being a non-disease state.<br /><br />This classification assists anesthesiologists in evaluating operative risk and planning care accordingly.

Keywords

American Society of Anesthesiologists

ASA Physical Status Classification

preoperative health

anesthesia risk

ASA I to ASA VI

systemic disease

emergency surgery

pregnancy classification

operative risk assessment

anesthesiologist care planning