Clinical risk calculator

Commonly used cardiovascular risk scores (Prefer)

American College of Surgeons NSQIP Surgical Risk Calculator (2023)

Others

External links

Surgical Outcome Risk Tool (2014)

RCRI

CAD (Ischemic heart disease)

Yes (+1)

No (+0)

CVA (Cerebrovascular disease)

Yes (+1)

No (+0)

History of heart failure

Yes (+1)

No (+0)

Insulin therapy for diabetes

Yes (+1)

No (+0)

Serum creatinine ≥ 2.0 mg/dL

Yes (+1)

No (+0)

Planned high risk procedure (intraperitoneal, intrathoracic, or vascular surgery)

Yes (+1)

No (+0)

Gupta NSQIP Risk Calculator for Perioperative MI and Cardiac arrest (MICA)

Age (Year)

Functional status

Independent

Partially dependent

Totally dependent

ASA class

1: Normal healthy patient

2: Mild systemic disease

3: Severe systemic disease

4: Severe systemic disease that is constant threat to life

5: Moribund, not expect to life without surgery

Creatinine

Normal (≤ 1.5 mg/dL, 133 µmol/L)

Elevated (>1.5 mg/dL, 133 µmol/L )

Unknown

Cardiac Risk Index in Noncardiac Surgery (Goldman, et. al.)

Age > 70 years

Yes (+5)

No (+0)

Myocardial infarction within 6 months

Yes (+10)

No (+0)

Signs of CHF: ventricular gallop or JVD

Yes (+11)

No (+0)

Significant aortic stenosis

Yes (+3)

No (+0)

Arrhythmia other than sinus or premature atrial contractions

Yes (+7)

No (+0)

5 or more PVC's per minute

Yes (+7)

No (+0)

PO2 <60 mmHg; PCO2 >50 mmHg; K <3 mEq/L; HCO3 <20 mEq/L; BUN >50 mg/dL; Creatinine >3 mg/dL; elevated SGOT; chronic liver disease; bedridden

Yes (+3)

No (+0)

Emergency surgery

Yes (+4)

No (+0)

Intraperitoneal, intrathoracic, aortic surgery

Yes (+3)

No (+0)

American University of Beirut (AUB)-HAS2 Cardiovascular Risk Index

Age (years)

< 75 (0)

≥ 75 (+1)

Hemoglobin (g/dL)

≥ 12 (0)

<12 (+1)

History of heart disease e.g. history of previous myocardial infarction, coronary angioplasty, cardiac surgery, heart failure, atrial fibrillation, or moderate/severe valvular disease confirmed by echocardiography

Yes (+1)

No (0)

Angina or dyspnea

Yes (+1)

No (0)

Vascular surgery

Yes (+1)

No (0)

Surgical urgency

Yes (+1)

No (0)

Geriatric-Sensitive Perioperative Cardiac Risk Index (GSCRI)

This calculator estimates the rate of perioperative myocardial infarction or cardiac arrest (MICA) in patients ≥65 years old.

CVA (Cerebrovascular disease)

Yes

No

ASA class

1: Normal healthy patient

2: Mild systemic disease

3: Severe systemic disease

4: Severe systemic disease that is constant threat to life

5: Moribund, not expect to life without surgery

Creatinine

Normal (≤ 1.5 mg/dL, 133 µmol/L)

Elevated (>1.5 mg/dL, 133 µmol/L )

Unknown

Functional status

Independent

Partially dependent

Totally dependent

History of heart failure

Yes

No (+0)

Diabetes mellitus

Yes

Yes, and insulin dependent

No (+0)

References

Thompson A, Fleischmann KE, Smilowitz NR, Aggarwal NR, Ahmad FS, Allen RB, Altin SE, Auerbach A, Berger JS, Chow B, Dakik HA, de las Fuentes L, Eisenstein EL, Gerhard-Herman M, Ghadimi K, Kachulis B, Leclerc J, Lee CS, Macaulay TE, Mates G, Merli GJ, Mukherjee D; Parwani P, Poole JE, Rich MW, Ruetzler K, Stain SC, Sweitzer B, Talbot AW, Vallabhajosyula S, Whittle J, Williams KA Sr. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM guideline for perioperative cardiovascular management for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;150:e351–e442.

Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, Sugarbaker DJ, Donaldson MC, Poss R, Ho KK, Ludwig LE, Pedan A, Goldman L. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999 Sep 7;100(10):1043-9.

Gupta PK, Gupta H, Sundaram A, Kaushik M, Fang X, Miller WJ, et al. Development and Validation of a Risk Calculator for Prediction of Cardiac Risk After Surgery. Circulation [Internet]. 2011 Jul 26 [cited 2025 May 21];124(4):381–7.

Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N. Engl J Med. 297:845, 1977.

Dakik HA, Chehab O, Eldirani M, Sbeity E, Karam C, Abou Hassan O, Msheik M, Hassan H, Msheik A, Kaspar C, Makki M, Tamim H. A New Index for Pre-Operative Cardiovascular Evaluation. J Am Coll Cardiol. 2019 Jun 25;73(24):3067-3078.

Alrezk R, Jackson N, Al Rezk M, et al. Derivation and Validation of a Geriatric-Sensitive Perioperative Cardiac Risk Index. J Am Heart Assoc. 2017; 6(11): e006648.