Cardiac Risk Index in Noncardiac Surgery (Detsky et. al.)

Select Criteria:
Coronary Artery Disease
Myocardial infarction
No history (0 points)
Within 6 months (10 points)
Beyond 6 months (5 points)
Canadian Cardiovascular Society Angina
Class I - II (0 points)
Class III (10 points)
Class IV (20 points)
Unstable angina within 3 months (10 points)
Pulmonary Edema
Never (0 points)
Within 1 week (10 points)
Ever (5 points)
Valvular Disease
Possible aortic stenosis of a critical nature (20 points)
Arrhythmias
Abnormal heart rhythm (other than sinus with premature atrial beats) (5 points)
5 or more PVC's / min (5 points)
General Medical Conditions
PO2 < 60; PCO2 > 50; K < 3; HCO3 < 20; BUN > 50; Creat > 3; elevated SGOT; chronic liver disease; bedridden (5 points)
Operation
Emergency (10 points)
Age
Age > 70 (5 points)
Results: Total Criteria Point Count:
Risk Index
0-5 Points:Class I 6% Complications
6-12 Points:Class II 7% Complications
13-25 Points:Class III 20% Complications
26-100 Points:Class IV 100% Complications
  1. Detsky AS, Abrams HB, McLaughlin JR, et. al. Predicting cardiac complications in patients undergoing noncardiac surgery. J Gen Int Med. 1:211, 1986.
  2. Detsky AS, Abrams HB, Forbath N, et. al. Cardiac assessment for patients undergoing noncardiac surgery. Arch Intern Med. 146:2131, 1986.
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