Perioperative medicine & outcomes
Age, ASA physical status and surgical outcomes: insights from a nationwide cohort study
Authors' conclusion
This study shows a strong association between ASA physical status and mortality across all ages in a contemporary adult surgical cohort.
Study context
- Population
- Adults aged ≥ 18 y undergoing major non-cardiac surgery, Swedish Perioperative Register, January 2019 to March 2023262,938 elective and 197,108 acute procedures
- Exposure
- ASA physical status 3 and ≥ 4 vs ASA physical status 1
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsregistry-based, Swedish Perioperative Register
- Registry-based
- Swedish Perioperative Register
Main finding
As reported in the abstract
30-day mortality (adjusted)
Each group vs ASA 1Odds ratio (95% CI)
ASA 3elective surgery; adjusted
13.7(7.5–25.0)
ASA 3acute surgery; adjusted
14.0(10.2–19.3)
ASA ≥ 4elective surgery; adjusted
62.2(33.5–115.5)
ASA ≥ 4acute surgery; adjusted
51.1(37.1–70.3)
- Crude 30-day mortality, elective surgery
- 1369 (0.5%)
- Crude 30-day mortality, acute surgery
- 10,602 (5.4%)
Observational data: associations, not effects.
Secondary outcomes
365-day mortality (crude)
- Elective surgery
- 10,437 (4.0%)
- Acute surgery
- 27,912 (14.2%)
Original publication
Age, ASA physical status and surgical outcomes: insights from a nationwide cohort study. Anaesthesia. Published 29 July 2025. doi:10.
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