Modified Aldrete Score

Checks whether the patient is ready for discharge from the PACU after anesthesia.

In the text below the calculator there is more information on the items in the score, its interpretation and on post anesthesia discharge factors.

The modified Aldrete score is used to evaluate patients from the Post Anaesthesia Care Unit (PACU), with the purpose to check whether they can be safely discharged.

The score accounts for consciousness, mobility, breathing, circulation, tegument color and O2 saturation.

This is the revised version of the original Aldrete score in which the O2 saturation item has been added.

Given that each of the six items is awarded from 0 to 2 points, the overall modified Aldrete score ranges from 0 to 12.

The higher the score, the more ready for discharge the patient is.

A score of 9 is considered as the cut off for initiating discharge.












O2 saturation

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Modified Aldrete Score explained

This health score checks the availability for discharge of patients from the Post Anaesthesia Care Unit (PACU).

It consists of 6 discharge factors, each accompanied by three differently weighted answer choices that depict a different patient status.

The overall score is then interpreted as to recommend or not discharge.

The following table introduces the items in the modified Aldrete score:

Item Answer choices (points)
Consciousness Fully awake (2)
Arousable (1)
Not responding (0)
Mobility Able to move four extremities on command (2)
Able to move two extremities on command (1)
Able to move 0 extremities on command (0)
Breathing Able to breathe deeply (2)
Dyspnea (1)
Apnea (0)
Circulation Systemic BP ≠ 20% of the preanesthetic level (2)
Systemic BP between 20% and 49% of the preanesthetic level (1)
Systemic BP ≠ 50% of the preanesthetic level (0)
Color Normal (2)
Pale, jaundiced, blotchy (1)
Cyanotic (0)
O2 saturation Maintaining O2 saturation >90% on room air (2)
Needs inhalation to maintain O2 saturation >90% (1)
O2 saturation <90% despite O2 supplementation (0)

The O2 saturation item is the one that has been added in the modified version, the rest of items being present in the original Aldrete score version as well.

The Aldrete models are well renowned for their use in the PACU setting. They are mostly limited by the fact that they account for general factors and cannot be adapted, for example, in different types of surgery.

Dr J. A. Aldrete, the creator of both scores is a Board Certified Anesthesiologist, the creator and President of the Arachnoiditis Foundation Inc. a non-profit organization.


Result interpretation

The total modified Aldrete score values range from 0 to 12. Scores closer to 0 indicate that the patient is closest to the anesthesia state.

Scores of 9 and above indicate that the patient can be discharged and the closer the score is to 12, the higher the chances for all anestethic, regardless of administering method, to have worn off.

Despite the score, guidelines require the existence of someone to escort and then continue to care for the patient after discharge.


Post anesthesia discharge factors

There are different evaluations that routinely take place to check the readiness of a patient to either be discharged entirely from hospital or to be moved to a different unit.

Most of these evaluations include items that check the conscious state of the patient, different motor and cognitive abilities.

The patient’s airways and breathing are checked, then mental status is evaluated. In order of importance, next is the state of the surgical site.

Other factors that are taken into account include the type of surgery the patient has underwent or the type of anesthetic that has been used.

For the latter, half-life, overall and side effect, as well as complications are taken into account.

One of the main recommendations for care after discharge is that of keeping the patient hydrated and drinking a lot of liquids. Rest for a set period of time is also recommended.


Recovery phases after surgery

The first phase focuses on gaining stability in functional organs and in most body constants. The second phase is one integrating the patient and their carer with life after surgery.

The table below presents the main characteristics of the two post op:

Characteristic Phase 1 Phase 2
Hemodynamically unstable stable
Supplemental oxygen yes no
Pain intervention yes little
Surgical site unstable stable
Arousal somnolent awakened
Focused on patient after care
Discomfort maximal diminishing

Original source

Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995; 7(1):89-91.

Other references

1. Aldrete JA, Kroulik D. A postanesthetic recovery score. Anesth Analg. 1970; 49(6):924-34.

2. Trevisani L, Cifalà V,Gilli G, Matarese V, Zelante A, Sartori S. Post-Anaesthetic Discharge Scoring System to assess patient recovery and discharge after colonoscopy. World J Gastrointest Endosc. 2013; 5(10): 502–507.

Specialty: Anesthesiology

Objective: Evaluation

Type: Score

No. Of Items: 6

Year Of Study: 1995

Article By: Denise Nedea

Published On: April 12, 2017

Last Checked: April 12, 2017

Next Review: April 12, 2023