The American Society of Anesthesiologists physical status classification has been modified a few times to increase the uniformity. The recent amendment was done in 2014 which has also incorporated some examples against each class. Still, sometimes I feel difficulty in assigning the class especially patients having a history of heavy smoking in the past, tobacco users, cancer patients, patients having multiple controlled or mild co-morbidities, etc. Do you also face the same situation? If so, in which cases?
Its a vague tool of perioperative risk assessment with many practical limitations.
Links: Article Anaesthesia risk stratification: Time to think beyond Americ...
Article Reliability of American Society of Anesthesiologists physica...
Article American Society of Anaesthesiologists Physical Status Classification
Regards- Rabiul.
Dear Dr. Habib Md Reazaul Karim
I agree with Dr. Rabiul Alam that ASA-PS has many practical limitations. E.g.: in cases with unknown medical history of hepatic or nephrologic diseases but the lab. results are higher than normal range, should it be ASA-PS I ? or not? the examples can be increased in clinical practice. my own opinion about ASA-PS is, its use as a clinical guide is very limited.
Thank you Mehmet Canturk , Rabiul Alam
I agree with you and I often face the situation. Recently, I have written two such letters too. Article Smoked for Years but Stopped a Few Months Back: Dilemma Rega...
Article American Society of Anesthesiologists physical status class:...
I am planning to observe the situation in our institute, and want to know the situations faced by others in different parts of the world. I agree that ASA-PS has its limitations and to reduce these limitations and variability, it was amended in 2014.
Now, it is important for us to know the situations which lead us to assignment variability. I believe, if we can find out these, the next amendment can address these issues to a great extent.
ASA gas low interreliability.
I would like to suggest the following article:
https://www.ncbi.nlm.nih.gov/m/pubmed/30424587/
Thank you very much Rabiul Alam Mehmet Canturk Alessandro De Cassai
I agree very much with you. After going through the original article Article The assignment of ASA-physical status relates to anesthesiol...
I got more interested in to this. Even I have written a letter in context to this article.Article American Society of Anesthesiologists physical status class:...
. Then I thought of knowing the different factors which affects this variability in the assignment. I found tobacco use/smoking definition as one of the dilemmaArticle Smoked for Years but Stopped a Few Months Back: Dilemma Rega...
Now, I am prospectively observing the ASA-PS allocations by residents in our institute and the reason for assigning the same, what points the resident gave weight-age and what are the points overlooked. I believe this will give more information. I am also searching similar experience from different practitioners of different places.
Thanking you all again
Good protocol and initiative! Go ahead Prof Habib Md Reazaul Karim. The following recent article of Anaesthesia may help you a little. Regards- Rabiul.
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