American Society of Anesthesiology Classification

(redirected from ASA IV)

American Society of Anesthesiology Classification

A system used by anesthesiologists to stratify severity of patients' underlying disease and potential for suffering complications from general anesthesia
American Society of Anesthesiology patient classification status
ASA I
Normal healthy Pt
ASA II
Pt with mild systemic disease; no functional limitation–eg, smoker with well-controlled HTN
ASA III
Pt with severe systemic disease; definite functional impairment–eg, DM and angina with relatively stable disease, but requiring therapy
ASA IV
Pt with severe systemic disease that is a constant threat to life–eg, DM + angina + CHF; Pts have dyspnea on mild exertion and chest pain
ASA V
Unstable moribund Pt who is not expected to survive 24 hours with or without the operation
ASA VI
Brain-dead Pt whose organs are removed for donation to another
E
Emergency operation of any type, which is added to any of the 6 above categories, as in ASA II E
References in periodicals archive ?
Hastalarin demografik verileri Karakteristikler Elektif LK Acil LK Yas (yil) 70,2 70,4 Cinsiyet (n, %) Kadin 51 (%69,9) 30 (%65,2) Erkek 22 (%30,1) 16 (%34,8) Ameliyat endikasyonu (n, %) Kronik kolesistit 55 (%75,3) 0 Akut kolesistit 0 43 (%93,4) Biliyer pankreatit 11 (%15,1) 3 (%6,6) Koledokolityazis 7 (%9,6) 0 ASA skoru (n, %) ASA I 6 (%8,2) 0 ASA II 42 (%57,5) 12 (%26,1) ASA III 20 (%27,4) 31 (%67,4) ASA IV 5 (%6,9) 3 (%6,5) ASA: American Society of Anesthesiology Tablo 2.
Serious adverse events were classified as ASA II (n = 1), ASA III (n = 4) and ASA IV (n = 1).
The second case occurred in 2013 in a 48-month old female patient classified as ASA IV, with a posterior fossa tumour who was taken to contrast-enhanced brain MRI and went into cardiopulmonary arrest 10 min into the start of anaesthesia.
The exclusion criteria were all paediatric patients age fifteen years and below as well as all patients with any other reason for a higher level of sedation (Ramsay Score of 5-6), such as head injury or neurological pathology; as well as all ASA IV patients, emergencies or above.
Furthermore, patients classed as ASA IV were over seven times more likely to have medical complications compared with those in class II.
ASA IV patients were more likely to be admitted to HDU.
It was only amongst ASA IV patients that this difference was lost but, within this subset, patient numbers were too small to allow any significant conclusions to be drawn.
Although the numbers are small, this suggests that it was only the least physically fit ASA IV patients who benefited from HDU care, while the more physically fit seemed to do worse in HDU.
Thus it is plausible that the patients categorized as ASA I-III in this study, were not unstable enough to benefit from HDU care and recovery was slowed, whereas the ASA IV patients were unstable enough to benefit from the more aggressive care and this shortened their recovery and length of stay.