The purpose of the grading system is simply to assess the degree of a patient’s “sickness” or “physical state” prior to selecting the anesthetic or prior to performing surgery.
ASA Physical Status Classification
|ASA PS Category||Preoperative Health Status||Comments, Examples|
|ASA PS 1||Normal healthy patient||No organic, physiologic, or psychiatric disturbance; excludes the very young and very old; healthy with good exercise tolerance|
|ASA PS 2||Patients with mild systemic disease||No functional limitations; has a well-controlled disease of one body system; controlled hypertension or diabetes without systemic effects, cigarette smoking without chronic obstructive pulmonary disease (COPD); mild obesity, pregnancy|
|ASA PS 3||Patients with severe systemic disease||Some functional limitation; has a controlled disease of more than one body system or one major system; no immediate danger of death; controlled congestive heart failure (CHF), stable angina, old heart attack, poorly controlled hypertension, morbid obesity, chronic renal failure; bronchospastic disease with intermittent symptoms|
|ASA PS 4||Patients with severe systemic disease that is a constant threat to life||Has at least one severe disease that is poorly controlled or at end stage; possible risk of death; unstable angina, symptomatic COPD, symptomatic CHF, hepatorenal failure|
|ASA PS 5||Moribund patients who are not expected to survive without the operation||Not expected to survive > 24 hours without surgery; imminent risk of death; multiorgan failure, sepsis syndrome with hemodynamic instability, hypothermia, poorly controlled coagulopathy|
|ASA PS 6||A declared brain-dead patient who organs are being removed for donor purposes|
- Owens WD, Felts JA, Spitznagel EL Jr. ASA physical status classifications: a study of consistency of ratings. Anesthesiology. 1978 Oct;49(4):239-43. [Medline]
- Mak PH, Campbell RC, Irwin MG; American Society of Anesthesiologists. The ASA Physical Status Classification: inter-observer consistency. American Society of Anesthesiologists. Anaesth Intensive Care. 2002 Oct;30(5):633-40. [Medline]
Created: Jan 30, 2012.