Table 1 Current Definitions and Examples of American Society of Anesthesiologists Physical Status (ASA-PS) Class

ASA-PS I

A normal healthy patient

Healthy, non-smoking, no or minimal alcohol use

ASA-PS II

A patient with mild systemic disease

Mild diseases only without substantive functional limitations.

Mild diseases only without substantive functional limitations. Examples include (but not limited to): current smoker, social alcohol drinker, pregnancy, obesity (30 < BMI < 40), well-controlled DM/HTN, mild lung disease

ASA-PS III

A patient with severe systemic disease

Substantive functional limitations; One or more moderate to severe diseases. Examples include (but not limited to): poorly controlled DM or HTN, COPD, morbid obesity (BMI ≥40), active hepatitis, Alcohol dependence or abuse, implanted pacemaker, moderate reduction in ejection fraction, ESRD undergoing regularly scheduled dialysis, premature infant PCA < 60 weeks, history (> 3 months) of MI, CVA, TIA, or CAD/stents.

ASA-PS IV

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

Recent (<  3 months) history of 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-PS V

A moribund patient who is not expected to survive without the operation

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-PS VI

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