A patient with severe systemic disease that is a constant threat to life is classed as which ASA grade?

• A. II or 2
• B. III or 3
• C. IV or 4
• D. V or 5

Answer: (C)

The main idea here is the ASA physical status classification, which rates preoperative risk based on the patient’s systemic health. The descriptor for ASA IV is severe systemic disease that is a constant threat to life, meaning the illness is ongoing and life-threatening despite treatment. This is why the patient fits ASA IV: their systemic disease is not just present, but continuously jeopardizing life and making anesthesia high risk.

To place it in context, ASA II is mild systemic disease without a constant threat to life, ASA III is severe systemic disease that limits activity but isn’t a constant life threat, ASA V describes a moribund patient not expected to survive without the operation, and ASA VI is a brain-dead organ donor.