American Society of Anesthesiologists Physical Status Classification System

Q: The American Society of Anesthesiologists (ASA)'s Level-6 physical status is the highest category classification, which means that a moribund patient is not expected to survive without an operation.

A) True

B) False

Answer: B

The criteria for assigning ASA class include the presence of a systemic disease that affects activity or is a threat to life. ASA class >2 confers a 4.87-fold increase in risk.

ASA 1 – Healthy.

ASA 2 – Mild systemic disease (e.g., well-controlled hypertension, stable, aѕthma, diabetes mellitus).

ASA 3 – Severe systemic disease (e.g., history of angina, СОΡD, poorly controlled hypertension, class 3 or higher obеsity

ASA 4 – Severe systemic disease with a constant threat to life (e.g., history of unstable angina, uncontrolled diabetes or hypertension, advanced renal, pulmonary, or hepatic dysfunction).

ASA 5 – Moribund patient not expected to survive without operation (e.g., ruptured aortic aneurysm).

ASA 6 – A declared brain-dead patient whose organs are being removed for donor purposes.

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References:

1. Knuf KM, Maani CV, Cummings AK. Clinical agreement in the American Society of Anesthesiologists physical status classification. Perioper Med (Lond). 2018;7:14

2. Horvath B, Kloesel B, Todd MM, Cole DJ, Prielipp RC. The Evolution, Current Value, and Future of the American Society of Anesthesiologists Physical Status Classification System. Anesthesiology. 2021 Nov 01;135(5):904-919.