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

 

History
		Age >70 years (5 points)
		Myocardial infarction within 6 months (10 points)
Cardiac Exam
		Signs of CHF: ventricular gallop or JVD (11 points)
		Significant aortic stenosis (3 points)
Electrocardiogram
		Arrhythmia other than sinus or premature atrial contractions (7 points)
		5 or more PVC's per minute (7 points)
General Medical Conditions
		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 (3 points)
Operation
		Emergency (4 points)
		Intraperitoneal, intrathoracic or aortic (3 points)

 
Important: Inputs must be complete to perform calculation.

 

Total Criteria Point Count:
 
     
 
Include literature references: Yes   No
 

Risk Index

 

0 to 5 Points:	Class I 1% Complications
6 to 12 Points:	Class II 7% Complications
13 to 25 Points:	Class III 14% Complications
26 to 53 Points:	Class IV 78% Complications

 

 

References

1. Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N. Engl J Med. 297:845, 1977. PubMed ID: 904659
2. Internet Site: ACP Clinical Guideline Resource, http://www.acponline.org/journals/annals/15aug97/ppcad1.htm

 

Associated Medical Subject Headings [MeSH]
 

Age Factors,   Aged,   Emergencies,   Female,   Heart Diseases,   Humans,   Male,   Middle Aged,   Myocardial Infarction,   Operative,   Postoperative Complications,   Prospective Studies,   Pulmonary Embolism,   Risk,   Surgical Procedures,   Tachycardia

 

Associated ICD10-CM Codes
 

	Z01.810	Encounter for preprocedural cardiovascular examination
	R09.89	Other specified symptoms and signs involving the circulatory and respiratory systems
	R94.31	Abnormal electrocardiogram [ECG] [EKG]
	R94.39	Abnormal result of other cardiovascular function study
	R94.30	Abnormal result of cardiovascular function study, unspecified

 

Associated ICD9-CM Codes
 

	794.30	Abn cardiovasc study nos
	794.39	Abn cardiovasc study nec
	794.31	Abnorm electrocardiogram
	785.9	Cardiovas sys symp nec
	V72.81	Preop cardiovsclr exam