Analysis of the American Society of Anesthesiologists Physical Status Scale Reliability in Anaesthesia Practice: An Observational Study

OBJECTIVE: Anaesthesiologists use the American Society of Anesthesiologists physical status (ASA PS) classification to assess patients’ overall health. The primary objective of this study was to predict the prognostic value regarding peri-operative variables until discharge from hospital and post-operative outcomes. The secondary objective was to evaluate the inter-rater agreement of the ASA scores assigned at the outpatient department (OPD) vs. operating theatres (OT). METHODS: A total of 227 adults scheduled for elective surgery were assigned the ASA grade in preoperative OPD and on the day of surgery. The type of anaesthesia and surgery were noted. The operating time, post-operative ventilation, intensive care unit (ICU) stay, post-operative stay, bronchopulmonary complications, cardiac complications, renal dysfunction and any mortality until discharge from hospital were noted. Descriptive statistics were used to report the primary objective. For the secondary objective, Pearson’s correlation test was used for inter-rater reliability. RESULTS: The ASA grading done at OPD and at OT was the same. It was found that the higher the ASA grade of a patient, the longer was the ICU stay. Patients with higher ASA PS scores were at a comparatively milder risk of developing remaining peri-operative and post-operative complications. CONCLUSION: The correlation was the highest with the ICU stay. The inter-rater ASA grades assignment at the clinics and the OT were found to be almost perfect.