ASA CLASSIFICATION

ASA physical
I II III IV V VI
status
Definition Healthy Mild systemic severe systemic severe systemic Moribund patient declared brain-
disease disease ; disease that is a who is not dead whose
substantive constant threat to expected to organs are being
functional life survive without removed for donor
limitations operation purposes
Age > 3 months to ≤ 3 months or ≥ Premature infant
<65 years 65 to 84 years PCA <60weeks or
≥ 85 years
Functional class Complete without Rest at completion Stop en route Unable to do; FC IV
distress; FC I because of because of
distress; FC II distress; FC III
Medical status Non organic, Single/multiple One or more End stage Clinically dead
physiologic or systemic diseases moderate to diseases and not whose organs are
psychiatric with good control severe diseases expected to being removed for
disturbance survive within 24 donor purposes
hours
No functional Functional Constant potential
limitations or vital limitations threat to life
organ involvement
Mortality rate 0.06 - 0.08 0.27 - 0.4 1.8 - 4.3 7.8 - 23 9.4 - 51
(%)
Emergency Additional "E" denotes Emergency surgery (An emergency is defined as existing when delay in treatment of the patient
status would lead to a significant increase in the threat to life or body part)
ASA physical
I II III IV V VI
status
CVS HT with BP ≤ HT ≥ 180/110 Recent (<3months) Ruptured
140/90 mmHg mmHg, history MI, CAD/stents, abdominal/
(>3months) of MI, ongoing ischemia thoracic
CAD/stents, or severe valve aneurysm, S/P
implanted dysfunction, severe CPR
pacemaker, EF reduction of EF,
moderate reduction uncontrolled
arrhythmia with
hemodynamic
instability, CHF

Respiratory Non smoking Current smoker, Poorly controlled Asthma with acute
mild lung disease, COPD, asthmatic exacerbation, OSA
well controlled attack > 2/week, with pulmonary
asthma, OSA severe OSA HT, ARDS

CNS well controlled history Recent (<3months) Intracranial bleed

epilepsy, (>3months) of CVA, TIA with mass effect
Parkinsonism, CVA, TIA, poor-
dementia, control
Alzeihmer's disease neurological
disease
Endocrine Well controlled Poorly controlled DKA, HHNK,
DM, hypo/hyper DM, symptomatic thyroid crisis,
thyroidism with hypo/hyper BMI≥45
clinical euthyroid; thyroid, BMI≥40
Overweight and
obesity type I-II
(BMI 30-39.99)
ASA physical
I II III IV V VI
status
Hematology anemia (Hct< symptomatic plt <50,000, INR
30%), thalassemia anemia ≥1.5 with bleeding
minor eg. trait, Hb (Hct<25%),
E, Hb CS,Hb H thalassemia major,
plt <50,000, INR
≥1.5
Renal Renal impairment CKD stage 3-4, ARD or ESRD not
stage 1-2, ESRD undergoing undergoing regular
electrolyte regular scheduled scheduled dialysis
imbalance without dialysis, or volume
symptom symptomatic overload, uremia,
electrolyte hepatorenal
imbalance syndrome
GI minimal alcohol social drinker, Alcohol active hepatitis, Ischemic bowel
use cirrhosis child A dependence or cirrhosis child C in the face of
abused, cirrhosis significant
child B cardiac pathology
or multiple
organ/system
dysfunction ,
hepatic
encephalopathy

OB Normal pregnancy pre existing Eclampsia, severe HELLP syndrome

disease in pre eclampsia,
pregnancy, GDM Gestational DM
(poor-control)

Metabolic normal/overweight Obesity I Obesity II, III Morbid obesity

Others SIRS, malnutrition septicemia Sepsis, DIC, shock, Massive trauma,

(BMI< 16.5 ), blunt trauma blunt trauma,
hypoalbuminemia (hemodynamic hemodynamic
(<2.5) stable) without instability with
inotropic drugs inotropic drug