ASA Classification: Made Easy

The purpose of the system is to assess and communicate a patient’s pre-anesthesia medical co-morbidities. The classification system alone does not predict the perioperative risks, but used with other factors (e.g., type of surgery, frailty, level of deconditioning), it can be helpful in predicting perioperative risks.

ASA gradeDefinitionMortality
INormal healthy0.05%
IIControlled mild systemic disease; no functional limitation0.5%
IIIUncontrolled severe systemic disease; functional limitationupto 5%
IVConstant threat to lifeupto 25%
VMoribund patients (not expected to survive 24 hours)upto 50%
VIBrain dead100%
Addition of “E” denotes Emergency.
ASA Classification

Some important examples

Smoker: ASA 2

Alcohol:

  • Social drinker: ASA 2
  • Alcohol dependence or abuse: ASA 3

Pregnancy: ASA 2

Obesity:

  • BMI 30-40: ASA 2
  • BMI >40: ASA 3

MI, CVA, TIA, CAD/stents:

  • >3 months: ASA 3
  • <3 months: ASA 4

Diabetes, Hypertension:

  • Controlled: ASA 2
  • Uncontrolled: ASA 3

Lung disease:

  • Mild: ASA 2
  • COPD: ASA 3

Further reading: http://www.kpcolorado.net/sites/default/files/files/KASC_2-04A_ASA_Classification_made_easy.pdf


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