Which ASA physical status class is associated with an approximately 2- to 3-times increased risk for postoperative complications?

• A. ASA I
• B. ASA II
• C. ASA IV
• D. ASA III

Answer: (D)

Postoperative risk rises with the severity of systemic disease as reflected by the ASA physical status. Healthy patients are ASA I, those with mild systemic disease are ASA II, and those with severe systemic disease that limits activity but is not a constant threat to life are ASA III. This level of disease typically corresponds to roughly a two- to three-fold increase in postoperative complications compared with ASA I. In contrast, ASA IV describes life-threatening systemic disease with even higher risk, and ASA I is the baseline with no increased risk. So the 2- to 3-times increase aligns with ASA III.