UNDERSTANDING ASA PHYSICAL STATUS AS A PHASE 4 MEDICAL UNDERGRADUATE - A RETROSPECTIVE ANALYSIS
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Keywords
ASA, CBME, Scoring Systems, Perioperative Morbidity.
Abstract
INTRODUCTION: Competency based medical education is the latest trend in medical education enabling the medical graduates to face, focus and evolve. This format of curriculum design allows elective postings as per choice for the medical undergraduates. Anaesthesiology as an elective is wonderful and offers a complete perspective of medicine and surgery. Starting from preanesthetic clinic going through various speciality operation theatres students are exposed to wide range of experiences. The American Society of Anaesthesiologists has formed a grading system based on physical status of a patient, to classify, group and assign the patients and offers a general idea of morbidity and mortality. In this study we wish to share the understanding of this ASA system as a phase 4 medical undergraduate.
AIM: To understand the art and science of assigning the physical status scoring system of American Society of Anaesthesiologists as a medical undergraduate.
OBJECTIVES:
- To group the patients by age, gender, system involved and comorbidities and analyse ASA scoring.
- To evaluate clinical application of ASA scoring system.
MATERIALS AND METHODS: All patients who were presented for elective surgeries to preanaesthetic clinic during January 2025 were taken up for the respective observational study.
Age, gender, diagnosis, surgery, organ system involved, comorbidities and ASA score as guided by the consultant and as per ASA guidelines were assigned to each patient. The results were tabulated and analysed.
RESULTS: 80 patients who attended preanaesthetic evaluation clinic during one month were taken up for analysis of a foresaid parameters. 40 males belonged to ASA 2 and 18 females were ASA 2, 12 males were ASA 3 and females (50%) were assigned to ASA 3, of the organ systems 100% of CNS disorders and lung diseases were ASA 3 in our study and 50% of oncology were ASA 3. Analysis of age showed 33 in 25 percentile, 45.5 in 50th and 60 in 75th percentile. The standard deviation with ASA was 0.75 and 2.25 in 75th percentile.
CONCLUSION: American Society of Anaesthesiologist Physical Status Scoring System is a simple and effective method involving history and severity of systemic disease which throws good light on anticipated perioperative problems. Elaborate investigations need not be thrusted on ASA 1 and 2 which may not be contributory to surgical outcome. ASA scoring is a simple tool which could be mastered by final year (phase 4) medical undergraduate which could contribute to good clinical practice on completing graduation.
References
[2] Joseph Maxwell Hendrix ; Emily H Garmen et al ASA Physical Status classification system updated 2025 Baylorscot & white Medical Centre affiliation.
[3] Kivrak S Haller G. Scores for preoperative risk evaluation of postopera mortality. Best pract Resclin Anaes 2021:35(1):115-34.
[4] Delahunt R Turnbull PRG. How cost effective are routine preoperative investigations. NZ Med J 1980:92:431-2.
[5] Kate Leslie, Lars I Eriksson et al scope of Modern Anesthetic Practice Ch 1 pg 2.
[6] Rachel A Hadlor Mask D Newman et al Risk of Anesthesia Ch 30 pg 892.
[7] Duminda N Wijeysundera et al preoperative evaluation Ch 31 pg 918.
[8] Arozullah AM, Daley J, Henderson WG, Khuri SF. Multifactorial risk index for predicting postoperative respiratory failure in men after major noncardiac surgery. The National Veterans Administration Surgical Quality Improvement Program. Ann Surg. 2000 Aug;232(2):242-53.
[9] Jesse Kiefer, Marty Myther et al Anesthetic Implications of Concurrent Diseases Ch 32 pg 999.
[10] Butterworth JF, Mackey DC, Wasnick JD. Preoperative assessment and perioperative documentation. Chap. 18. In: Morgan and Mikhali’s clinical anaesthesiology. 6th edn. McGraw-Hill Education 2018: P. 473.
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Dr. Rajashri G
Phase 4 Medical Undergraduate, Department of Anaesthesia, Dhanalakshmi Srinivasan Medical College and Hospital. Siruvachur, Perambalur, Tamil Nadu, India.
Dr. Mutharasan
Assistant Professor, Department of Anaesthesia, Dhanalakshmi Srinivasan Medical College and Hospital. Siruvachur, Perambalur, Tamil Nadu, India.
Dr. Geetha J
Associate Professor, Department of Anesthesialogy, Dhanalakshmi Srinivasan Medical College and Hospital, Siruvachur, Perambalur, Tamil Nadu, India.