ASA Physical Status Classification System

ASA 6

A declared brain dead patient whose organs are being removed for donor purposes

ASA 3

A patient with severe systemic disease examples- substantive functional limitations, one or more, moderate to severe diseases 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, for CAD/stents

ASA 4

A patient with severe systemic disease that is a constant threat to life examples 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 5

a moribund patient who is not expected to survive without the operation. examples 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 1

a normal healthy patient example- Healthy, non-smoking, no or minimal alcohol use

ASA 2

a patient with mild systemic disease examples- mild diseases only without substantive functional limitations. current smoker social alcohol drinker pregnancy obesity (30<BMI<40) well-controlled DM/HTN/mild lung disease

ASA classification

higher ASA class, higher the risks An E is added to the status number to designate an emergency operation