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Table 6 American Society of Anesthesiology Physical Status (ASA-PS) Classification System.

From: The Utstein template for uniform reporting of data following major trauma: A joint revision by SCANTEM, TARN, DGU-TR and RITG

ASA-PS 1 A normal healthy patient.
Guidelines: No organic, physiologic, biochemical or psychiatric disturbance. Any disorder is localized, without systemic effects. Smoking <5 cigarettes/day.
Example: Healthy non-smoker, admitted for varicose vein operation.
ASA-PS 2 A patient with mild systemic disease.
Guidelines: Present pathology might imply specific measures or anaesthesia related precautions. The disturbance(s) might be caused by the condition to be surgically treated or by another pathologic process. Smoking >5 cigarettes/day.
Examples: Mild organic heart disease. Uncomplicated diabetes mellitus (type 1 or 2).
Benign hypertension without complications. Healthy patient with trismus.
ASA-PS 3 A patient with severe systemic disease.
Examples: Diabetes mellitus with organ complications. Disabling heart disease. Moderate to severe respiratory disease. Angina pectoris. Myocardial infarction >6 months ago.
ASA-PS 4 A patient with severe systemic disease that is a constant threat to life.
Guidelines: The disease is not necessarily related to the condition to be surgically treated, neither is it necessarily improved by the surgical intervention per se.
Examples: Malignant hypertension. Myocardial infarction <6 months ago. Severe liver, kidney, respiratory, or endocrine dysfunction. Manifest cardiac failure. Unstable angina pectoris. Subarachnoid haemorrhage – patient awake or somnolent.
ASA-PS 5 A moribund patient who is not expected to survive without the operation.
Examples: Patient in circulatory shock because of ruptured aortic aneurysm. Deeply comatose patient with intracranial haemorrhage.
ASA-PS 6 A declared brain-dead patient whose organs are being removed for donor purposes.
  1. The six ASA-PS headings are from the American Society of Anaesthesiologists [65]. The guidelines and examples were translated from the Norwegian edition [66] by Skaga et al. [6].
  2. For the Utstein Template, the ASA-PS classification system should solely be used to categorise pre-injury comorbidity. Derangements resulting from the injury should not be considered.