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ASA Physical Status Classification System

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ASA Physical Status Classification System, ASA Physical Status, American Society Anesthesiology Physical Status, ASA-PS

  • Scoring
  • ASA 1 - Healthy patient
  1. No Tobacco use
  2. Minimal Alcohol use
  • Scoring
  • ASA 2 - Mild systemic disease
  1. Current Tobacco use
  2. Frequent social Alcohol use
  3. Pregnancy
  4. Obesity (BMI 30-40)
  5. Well controlled Diabetes Mellitus
  6. Mild lung disease
  • Scoring
  • ASA 3 - Moderate to severe systemic disease with significant functional limitations
  1. Poorly controlled Diabetes Mellitus
  2. Poorly controlled Hypertension
  3. Moderate to severe COPD
  4. Morbid Obesity (BMI>40)
  5. Active hepatitis
  6. Alcohol Dependence or abuse
  7. Heart Failure with moderately reduced ejection fraction
  8. ESRD requiring regularly scheduled Dialysis
  9. History of coronary disease (MI, stents, bypass) with last event more than 3 months ago
  10. History of Cerebrovascular Disease (e.g. CVA, TIA) with last event more than 3 months ago
  11. Multisystem congenital disorders (e.g. Down Syndrome, Cerebral Palsy)
  • Scoring
  • ASA 4 - Severe systemic, life-threatening disease
  1. History of coronary disease (MI, stents, bypass) with last event LESS THAN 3 months ago, or ongoing cardiac ischemia
  2. History of Cerebrovascular Disease (e.g. CVA, TIA) with last event LESS THAN 3 months ago
  3. Severe valvular dysfunction or severe reduction in ejection fraction
  4. Sepsis or DIC
  5. Acute or Chronic Renal Failure not on regular Dialysis
  • Scoring
  • ASA 5 - Moribund patient without expected survival through surgery
  1. Ruptured aortic aneurysm
  2. Massive Trauma
  3. Intracranial Bleeding with mass effect
  4. Ischemic Bowel with multiple, serious underlying comorbidities
  • Scoring
  • ASA 6 - Brain Death
  1. Organ removal for donation