Is ASA Classification a Valid Prognosticator in Octogenarians? Probablynot

Assessment of the state of health prior to surgery is the main responsibility of an anesthesiologist. The American Society of Anesthesiologists (ASA) has long adopted a grading system to classify the general health status of the patients preoperatively. Although the basis of this classification is very crude, it has been strongly associated with the outcome of the patients after surgery. However, as the population grows older, octogenarians are making a larger portion of our community. Majority of the patients in this age group suffer from chronic medical conditions and therefore, ASA classification categorizes them as ASA3 physical status. This classification significantly limits the ability to predict the clinical postoperative outcome in this growing group of population. This commentary is basically reviewing a need for additional tools or further modification of ASA classification that may help the anesthesia clinicians to identify the higher risk population.