MedHubMedical calculators

Detsky Cardiac Risk Index

Estimates cardiac risk of noncardiac surgery using clinical and surgical factors.

When to use

Adults before major noncardiac surgery, to estimate perioperative cardiac risk.

Pearls and pitfalls
  • Class IV angina and critical aortic stenosis score 20 points each.
  • The total is classified as low, moderate and high risk, with approximate event probabilities.
  • The index predates troponin advances and perioperative management; use with current judgment.
  • It does not replace assessment of functional capacity, comorbidities and surgery type.

Age above 70 years

Myocardial infarction in the last 6 months

Myocardial infarction more than 6 months ago

Unstable angina in the last 6 months

Class III angina

Class IV angina

Pulmonary edema ever

Pulmonary edema in the last week

Critical aortic stenosis

Rhythm other than sinus or atrial premature beats

More than 5 premature ventricular contractions per minute

Poor general medical status

Emergency surgery

0 points

Low risk

Keep routine preoperative assessment and control risk factors.

Formula

Add factors weighted 5, 10 or 20 points according to the item.

Evidence

Index derived and validated to predict cardiac complications after noncardiac surgery.

References

  1. Detsky AS, Abrams HB, McLaughlin JR, et al. Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med. 1986;1(4):211-219. doi:10.1007/BF02596184

Frequently asked questions

What is Detsky Cardiac Risk Index?

Estimates cardiac risk of noncardiac surgery using clinical and surgical factors. Adults before major noncardiac surgery, to estimate perioperative cardiac risk.

How is the result calculated?

Add factors weighted 5, 10 or 20 points according to the item.

How should the result be interpreted?

Index derived and validated to predict cardiac complications after noncardiac surgery.

What are the sources?

Detsky AS, Abrams HB, McLaughlin JR, et al. Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med. 1986;1(4):211-219.

Updated