ClassDefinition Rates of PPCs by Class, % IA normally healthy patient1.2 IIA patient with mild systemic disease5.4 III A patient with severe systemic disease that is not incapacitating11.4 IV A patient with an incapacitating systemic disease that is a constant threat to life10.9 V A moribund patient who is not expected to survive for 24 h with or without operationNA VI A declared brain-dead patient whose organs are being removed for donor purposesNA ASA Physical Status Classification
Case 57 y/o female presents for pre-operative pulmonary evaluation for right total hip replacement – OSA – noncompliant – 32 pack years – Arthritis of right hip – DM – Morbid Obesity – BMI 40.4 Kg/m 2
Fletcher CM, Peto R. BMJ. 1977;1:1645-1648. Smoked regularly and susceptible to effects of smoke Never smoked or not susceptible to smoke Stopped smoking at 45 (mild COPD) Stopped smoking at 65 (severe COPD) Disability Death FEV 1 (% of value at age 25) 25 50 75 100 0 Age (years) 255075 COPD Risk and Smoking Cessation
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