Why the study?
On its 80th anniversary, reviewing the history, development, controversies, interrater reliability problems, and limitations of the American Society of Anesthesiologists Physical Status classification system as a risk predictor was timely.
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Design
Review
ASA PS classification carries documented limitations and controversies; leaves open refinement and validation for contemporary perioperative cardiac risk assessment.
The American Society of Anesthesiologists (ASA) Physical Status classification system celebrates its 80th anniversary in 2021. Its simplicity represents its greatest strength as well as a limitation in a world of comprehensive multisystem tools. It was developed for statistical purposes and not as a surgical risk predictor. However, since it correlates well with multiple outcomes, it is widely used-appropriately or not-for risk prediction and many other purposes. It is timely to review the history and development of the system. The authors describe the controversies surrounding the ASA Physical Status classification, including the problems of interrater reliability and its limitations as a risk predictor. Last, the authors reflect on the current status and potential future of the ASA Physical Status system.
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Horváth et al. (2021) studied this question.
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