Surgery

Detsky's Modified Cardiac Risk Index

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Detsky's Modified Cardiac Risk Index

  • Indications
  1. ACP Preoperative Cardiac Risk Assessment
  • Risk Factors
  • Patient
  1. Age older than 70 years: 5 points
  2. Prior Myocardial Infarction
    1. Last infarction within 6 months: 10 points
    2. Last infarction more than 6 months ago: 5 points
  3. Unstable Angina within last 6 months: 10 points
  4. Angina Pectoris
    1. Canadian Angina Class 3: 10 points
    2. Canadian Angina Class 4: 20 points
  5. Alveolar Pulmonary Edema
    1. Pulmonary Edema within one week: 10 points
    2. Pulmonary Edema at any time: 5 points
  6. Suspected Critical Aortic Stenosis: 20 points
  7. Arrhythmia
    1. Rhythm other than sinus or sinus with PACs: 5 points
    2. More than five premature ventricular beats: 5 points
  8. Emergency surgery: 10 points
  9. Poor general medical status: 5 points
    1. Based on Goldman Risk Index
  • Interpretation
  1. Class 1: Points 0-15 (Low risk)
  2. Class 2: Points 20-30 (Moderate risk)
  3. Class 3: Points >30 (High risk)
  • References
  1. Detsky (1986) J Gen Intern Med 1:213 [PubMed]