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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)

 
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 PubMed Logo
  2. Internet Site: ACP Clinical Guideline Resource, http://www.acponline.org/journals/annals/15aug97/ppcad1.htm

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

 
Associated ICD9-CM Codes
 
   794.30Abn cardiovasc study nos
   794.39Abn cardiovasc study nec
   794.31Abnorm electrocardiogram
   785.9Cardiovas sys symp nec
   V72.81Preop cardiovsclr exam

 
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