Objective: To evaluate the agreement of the American Society of Anesthesiologists physical status (ASA-PS) classification in clinical practice between anesthesia residents and research team and association with perioperative complications.

Materials and Methods: A cohort study of 1,684 patients that underwent elective surgery were classified conventional ASA-PS classification by the anesthesia resident and the research team. The measurement of agreement of ASA-PS scoring was done between the two groups using Kappa coefficient (κ). The results were compared by using with chi-square test and two-sample independent student t-test. The perioperative complications were recorded.

Results: Only 62.7% of the studied patients were classified at the same level between the anesthesia residents and the research team. The anesthesia residents classified in higher level than the research team statistically (p<0.01) with a Kappa coefficient of 0.345 (95% CI 0.31 to 0.37). The weighted Kappa statistic was 0.428 (95% CI 0.39 to 0.45). All the ASA classification by the research team or by the anesthesia residents and modified ASA classification associated with perioperative complication, which significantly increased with higher ASA-PS score.

Conclusion: The present study was a large single-tertiary institution cohort study. The ASA-PS rating score had ‘moderate’ agreement in clinical practice. The ASA-PS score is one important tool associated with perioperative complications.

Keywords: ASA-PS classification, Modified 7-grade preoperative status assessment, Agreement of ASA-PS classification, postoperative complications

Received 8 Feb 2019 | Revised 2 May 2019 | Accepted 9 May 2019