Class 1
Normal healthy
Class 2
Mild systemic disease
Class 3
Severe systemic disease
Class 4
Severe systemic disease constant threat to life
Class 5
Don’t expect to survive without operation
Example of class 1
Non smoker
No/minimal alcohol
Example of class 2
Smoker Social drinker Pregnant BMI 30-40 Well controlled HTN and diabetes
Example of class 3
Poorly controlled HTN or diabetes BMI >40 COPD Hepatitis Alcohol dependence ESRD + dialysis MI or CVA >3 months ago Pacemaker Ejection faction <40%
Examples of class 4
MI or CVA in past 3 months
Ejection fraction <25%
ESRD without dialysis
Severe valve disease
Examples of class 5
Ruptured AAA
Trauma
Multiple organ dysfunction
Intracranial bleed