Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain Management1993-65082687-1394Eco-Vector9004110.17816/RA90041Review ArticleUpdated classification of the physical condition of patients of the american society of anesthesiologistsKoriachkinVictor A.<p>MD, PhD, DSc, Professor</p>vakoryachkin@mail.ruhttps://orcid.org/0000-0002-3400-8989LevinYaakov I.doctorlevin@yandex.ruhttps://orcid.org/0000-0002-5599-4706ZabolotskiiDmitry V.<p>MD, PhD, DSc</p>zdv4330303@gmail.comhttps://orcid.org/0000-0002-6127-0798KhinovkerVladimir V.<p>MD, PhD</p>vhinov@hotmail.comhttps://orcid.org/0000-0002-3162-6298SafinRustam P.<p>MD, PhD, DSc, Professor</p>safin_r.r@hotmail.comhttps://orcid.org/0000-0003-0960-7426Saint-Petersburg State Pediatric Medical UniversityMedical center “MEDHELP”Federal Siberian Research Clinical CentreMari state University150420211521011060912202109122021Copyright © 2021, Eco-Vector2021<p>The American Society of Anesthesiologists (ASA) Classification of Physical Status is a widely used system for assessing the preoperative status of patients. The ASA class definitions have been amended several times since 1941, which caused some difficulties in using the classification. There are some difficulties in the assessments, especially between the III and IIIII classes of the ASA. To overcome this problem, clinical samples presented in the latest edition of the classification play a significant role. In this article, we have presented an updated classification of the physical condition of patients on the ASA scale before anesthesia and surgery, which is sufficiently simple, reproducible, and can be successfully used not only in adults, but also in pediatric and obstetric anesthesiology.</p>аnesthesiaASAphysical status classificationpreoperative assessmentанестезияASAклассификация физического статусапредоперационная оценка[Saklad M. Grading of patients for surgical procedures. Anesthesiology. 1941;2(3):281–284.][Visnjevac O, Davari-Farid S, Lee J, et al. The effect of adding functional classification to ASA status for predicting 30-day mortality. Anesth Analg. 2015;121(1):110–116. doi: 10.1213/ANE.0000000000000740][Dripps RD, Lamont A, Eckenhoff JE. The role of anesthesia in surgical mortality. JAMA. 1961;178:261–266. doi: 10.1001/jama.1961.03040420001001][Dripps RD. New classification of physical status. Anesthesiology. 1963;24: 111.][Fitz-Henry J. The ASA classification and peri-operative risk. Ann R Coll Surg Engl. 2011;93(3):185–187. doi: 10.1308/rcsann.2011.93.3.185a][Peacock O, Bassett MG, Kuryba A, et al. Thirty-day mortality in patients undergoing laparotomy for small bowel obstruction. Br J Surg. 2018;105(8):1006–1013. doi: 10.1002/bjs.10812][Soyalp C, Yuzkat N, Kilic M, et al. Operative and prognostic parameters associated with elective versus emergency surgery in a retrospective cohort of elderly patients. Aging Clin Exp Res. 2019;31(3):403–410. doi: 10.1007/s40520-018-0976-z][Knuf KM, Maani CV, Cummings AK. Clinical agreement in the American Society of Anesthesiologists physical status classification. Perioper Med (Lond). 2018;7:14. doi: 10.1186/s13741-018-0094-7][Curatolo C, Goldberg A, Maerz D, et al. ASA physical status assignment by non-anesthesia providers: Do surgeons consistently downgrade the ASA score preoperatively? J Clin Anesth. 2017;38:123–128. doi: 10.1016/j.jclinane.2017.02.002][Portier K, Ida KK. The ASA Physical Status Classification: What Is the Evidence for Recommending Its Use in Veterinary Anesthesia?-A Systematic Review. Front Vet Sci. 2018;5:204. doi: 10.3389/fvets.2018.00204][Markovic DZ, Jevtovic-Stoimenov T, Stojanovic M, et al. Cardiac biomarkers improve prediction performance of the combination of American Society of Anesthesiologists physical status classification and Americal College of Surgeons National Surgical Quality Improvement Program calculator for postoperative mortality in elderly patients: a pilot study. Aging Clin Exp Res. 2019;31(9):1207–1217. doi: 10.1007/s40520-018-1072-0][Barbeito A, Muir HA, Gan TJ, et al. Use of a modifier reduces inconsistency in the American Society of Anesthesiologists Physical Status Classification in parturients. Anesth Analg. 2006;102(4):1231–1233. doi: 10.1213/01.ane.0000198564.59290.ee][Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status – historical perspectives and modern developments. Anaesthesia. 2019;74(3):373–379. doi: 10.1111/anae.14569]