Gupta et al reported a cardiac risk calculator for patients undergoing surgery. This is based on the 2007 NSQIP database. The authors are from Creighton University, University of Pittsburgh and the University of Nebraska.
Patient selection: surgery
Outcome: perioperative myocardial infarction or cardiac arrest
Parameters:
(1) functional status
(2) ASA class
(3) serum creatinine
(4) age in years
(5) type of surgery
|
Parameter |
Finding |
Points |
|
functional status |
independent |
0 |
|
|
partially dependent |
0.65 |
|
|
totally dependent |
1.03 |
|
ASA |
ASA 1 |
-5.17 |
|
|
ASA 2 |
-3.29 |
|
|
ASA 3 |
-1.92 |
|
|
ASA 4 |
-0.95 |
|
|
ASA 5 |
0 |
|
serum creatinine |
<= 1.5 mg/dL |
0 |
|
|
> 1.5 mg/dL |
0.61 |
|
|
missing |
-0.10 |
|
age in years |
|
0.02 * (years) |
|
type of surgery |
anorectal |
-0.16 |
|
|
aortic |
1.6 |
|
|
bariatric |
-0.25 |
|
|
brain |
1.4 |
|
|
breast |
-1.61 |
|
|
cardiac |
1.02 |
|
|
ENT |
0.71 |
|
|
foregut, liver, pancreas, biliary |
1.39 |
|
|
gallbladder, adrenal, appendix, spleen |
0.59 |
|
|
intestinal |
1.14 |
|
|
neck |
0.18 |
|
|
OB/GYN |
0.76 |
|
|
orthopedic |
0.8 |
|
|
other abdomen |
1.13 |
|
|
peripheral vascular |
0.86 |
|
|
skin |
0.54 |
|
|
spine |
0.21 |
|
|
thoracic |
0.4 |
|
|
vein |
-1.09 |
|
|
urology |
-0.26 |
|
|
hernia |
0 |
X =
= SUM(points for all of the parameters) - 5.25
probability of myocardial infarction or cardiac arrest =
= 1/ (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.884.
Purpose: To evaluate a patient undergoing surgery using the cardiac risk calculator of Gupta.
Specialty: Cardiology, Anesthesiology, Surgery, general
Objective: risk factors
ICD-10: Y65,
