Zusammenfassung
Die Klassifikation der American Society of Anesthesiologists (ASA-Klassifikation) ist eine flächendeckend angewandte Kategorisierung des präoperativen Status von Patienten. Sie hat einen guten prädiktiven Wert bezüglich der perioperativen Morbidität und Letalität. Die Definitionen der ASA-Klassen wurden seit 1941 mehrfach verändert. In der aktuellen Literatur wird die aktuell gültige Klassifikation jedoch nicht einheitlich zitiert. Hierbei existieren insbesondere bei den ASA-Klassen 3, 4 und 5 konkurrierende Definitionen. Die hohe Variabilität der individuellen Eingruppierung durch unterschiedliche Anästhesisten ist aber auch durch bisher fehlende Beispieldiagnosen zu erklären. Seit 2014 wird von der ASA ein Beispielkatalog für Diagnosen zur vereinfachten Klassifikation vorgehalten. Dieser hat bisher im deutschsprachigen Raum nur begrenzt Aufmerksamkeit gefunden. Der vorliegende Beitrag beschreibt den Wandel der ASA-Klassifikation über die letzten fast 75 Jahre und fasst die aktuell gültige Definition zusammen.
Abstract
The American Society of Anesthesiologists classification of physical status (ASA PS) is a widely used system for categorizing the preoperative status of patients. The ASA class is a good independent predictor of perioperative morbidity and mortality. The definitions of the ASA classes have been amended several times since 1941, resulting in inconsistent and confusing usage in the current literature. Conflicting definitions of ASA PS exist, particularly for classes III, IV and V. The high variability of individual classifications by different anesthesiologist, however, can be explained by the previous lack of examples for diagnoses. In 2014, the ASA has added a catalogue of examples for a simplified definition for classification of the ASA PS. This has so far received limited attention in German-speaking countries. This article describes the transition of the ASA classification over the past 75 years und summarizes the currently valid definitions.
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T. Irlbeck, B. Zwißler und A. Bauer geben an, dass kein Interessenkonflikt besteht.
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Irlbeck, T., Zwißler, B. & Bauer, A. ASA-Klassifikation. Anaesthesist 66, 5–10 (2017). https://doi.org/10.1007/s00101-016-0246-4
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DOI: https://doi.org/10.1007/s00101-016-0246-4