Updated classification of the physical condition of patients of the american society of anesthesiologists

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Abstract

The American Society of Anesthesiologists (ASA) Classification of Physical Status is a widely used system for assessing the preoperative status of patients. The ASA class definitions have been amended several times since 1941, which caused some difficulties in using the classification. There are some difficulties in the assessments, especially between the I–II and II–III classes of the ASA. To overcome this problem, clinical samples presented in the latest edition of the classification play a significant role. In this article, we have presented an updated classification of the physical condition of patients on the ASA scale before anesthesia and surgery, which is sufficiently simple, reproducible, and can be successfully used not only in adults, but also in pediatric and obstetric anesthesiology.

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About the authors

Victor A. Koriachkin

Saint-Petersburg State Pediatric Medical University

Email: vakoryachkin@mail.ru
ORCID iD: 0000-0002-3400-8989
SPIN-code: 6101-0578

MD, PhD, DSc, Professor

Russian Federation, 2, Litovskaya, Saint Petersburg, 194100

Yaakov I. Levin

Medical center “MEDHELP”

Email: doctorlevin@yandex.ru
ORCID iD: 0000-0002-5599-4706
SPIN-code: 6154-5684
Russian Federation, 70, Vareikisa st., Voronezh, 394026

Dmitry V. Zabolotskii

Saint-Petersburg State Pediatric Medical University

Email: zdv4330303@gmail.com
ORCID iD: 0000-0002-6127-0798
SPIN-code: 6726-2571

MD, PhD, DSc

Russian Federation, 2, Litovskaya, Saint Petersburg, 194100

Vladimir V. Khinovker

Federal Siberian Research Clinical Centre

Email: vhinov@hotmail.com
ORCID iD: 0000-0002-3162-6298
SPIN-code: 8640-9591

MD, PhD

Russian Federation, 26, 2, Kolomenskaya st., Krasnoyarsk, 660037

Rustam P. Safin

Mari state University

Author for correspondence.
Email: safin_r.r@hotmail.com
ORCID iD: 0000-0003-0960-7426

MD, PhD, DSc, Professor

Russian Federation, 30, 56, H.Mushtary st., Kazan, 420015

References

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  3. Dripps RD, Lamont A, Eckenhoff JE. The role of anesthesia in surgical mortality. JAMA. 1961;178:261–266. doi: 10.1001/jama.1961.03040420001001
  4. Dripps RD. New classification of physical status. Anesthesiology. 1963;24: 111.
  5. Fitz-Henry J. The ASA classification and peri-operative risk. Ann R Coll Surg Engl. 2011;93(3):185–187. doi: 10.1308/rcsann.2011.93.3.185a
  6. Peacock O, Bassett MG, Kuryba A, et al. Thirty-day mortality in patients undergoing laparotomy for small bowel obstruction. Br J Surg. 2018;105(8):1006–1013. doi: 10.1002/bjs.10812
  7. Soyalp C, Yuzkat N, Kilic M, et al. Operative and prognostic parameters associated with elective versus emergency surgery in a retrospective cohort of elderly patients. Aging Clin Exp Res. 2019;31(3):403–410. doi: 10.1007/s40520-018-0976-z
  8. Knuf KM, Maani CV, Cummings AK. Clinical agreement in the American Society of Anesthesiologists physical status classification. Perioper Med (Lond). 2018;7:14. doi: 10.1186/s13741-018-0094-7
  9. Curatolo C, Goldberg A, Maerz D, et al. ASA physical status assignment by non-anesthesia providers: Do surgeons consistently downgrade the ASA score preoperatively? J Clin Anesth. 2017;38:123–128. doi: 10.1016/j.jclinane.2017.02.002
  10. Portier K, Ida KK. The ASA Physical Status Classification: What Is the Evidence for Recommending Its Use in Veterinary Anesthesia?-A Systematic Review. Front Vet Sci. 2018;5:204. doi: 10.3389/fvets.2018.00204
  11. Markovic DZ, Jevtovic-Stoimenov T, Stojanovic M, et al. Cardiac biomarkers improve prediction performance of the combination of American Society of Anesthesiologists physical status classification and Americal College of Surgeons National Surgical Quality Improvement Program calculator for postoperative mortality in elderly patients: a pilot study. Aging Clin Exp Res. 2019;31(9):1207–1217. doi: 10.1007/s40520-018-1072-0
  12. Barbeito A, Muir HA, Gan TJ, et al. Use of a modifier reduces inconsistency in the American Society of Anesthesiologists Physical Status Classification in parturients. Anesth Analg. 2006;102(4):1231–1233. doi: 10.1213/01.ane.0000198564.59290.ee
  13. Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status – historical perspectives and modern developments. Anaesthesia. 2019;74(3):373–379. doi: 10.1111/anae.14569

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