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The Evolution, Current Value, and Future of the American Society of Anesthesiologists Physical Status Classification System

It was recognized from the time of its introduction that the severity of coexisting diseases and the functional status of the patient are vital parameters to stratify patients before surgery. This system was not designed, developed, or intended to predict perioperative risk. Nevertheless, many subsequent publications have shown that the ASA Physical Status classifications are strongly correlated with outcome, either independently or in conjunction with other information. When combined with other factors (e.g., age, type and complexity of surgery, frailty, nutritional status, end-organ dysfunction, among others), the ASA Physical Status classification can contribute to the assessment of risk…

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Articles of Interest

The ASA Physical Classification System

Before referring for sedation in primary care, it’s important to make sure that the patient’s health fits into the ASA 1 and 2 categories to ensure as safe as sedation as possible. In simple terms, ASA 2 is a patient with a controlled mild systemic disease. ASA 3 is severe uncontrolled. Obese patients with BMI > 40 are not usually suitable for primary care sedation.

A review of ASA physical status – historical perspectives and modern developments

The American Society of Anesthesiologists (ASA) physical status is a tool commonly used to classify a patient's physical fitness before surgery. Since its introduction in 1941 it has undergone very few modifications to improve its reliability and to eliminate subjectivity, despite vast changes in both surgical and anaesthetic technique

Compliance Series: Anesthesiology, Let’s Get Physical with Our Documentation

When you administer anesthesia to a patient with a BMI over 40 or evaluate a patient who has chronic obstructive pulmonary disease, you may find yourself questioning what ASA status is most appropriate for that individual.

Reliability of the ASA Physical Status Classification System in Predicting Surgical Morbidity: a Retrospective Analysis

While there have been attempts to clarify exact definitions of the six classes, it is unclear how consistently they are applied in routine clinical practice.

The ASA classification and peri-operative risk

The ASA classification for a particular patient is based on systemic disease. The extent of this disease is evident from the patient's past medical history and medication list, and the amount of limitation that the disease causes to his or her everyday life.

The updated ASA classification

The American Society of Anesthesiologists (ASA) classification is renowned and used in many clinical and scientific contexts as a system for risk stratification of surgical patients. The updated version of the ASA classification attempts to facilitate the correct application of the ASA categories for users across all disciplines by providing approved examples of diseases and acute conditions. The addition of specific patient groups to the classification provides the user with further guidance.

Resources

ASA Classifications

Good summary of the ASA (American Society of Anesthesiologists) Classification...

ASA Physical Status/ASA Classification

About the creator - Meyer Saklad, MD, (d. 1979) was chief of anesthesiology at Rhode Island Hospital. He also served as part of the Unitarian Service Committee’s medical missions in Japan. Dr. Saklad’s primary research was focused on pharmacology of anesthetics, inhalation anesthesia, endotracheal anesthesia, spinal anesthesia, and oxygen therapy.

StatPearls

The American Society of Anesthesiologists (ASA) physical status classification system came about to offer perioperative clinicians a simple categorization of a patient's physiological status that can help predict operative risk. The ASAPS originated in 1941 and has seen some revisions since that time.