Gupta Perioperative Cardiac Risk

By clicking on the “Submit” button below, you acknowledge that you have read, understand, and agree to be bound by the terms of the QxMD Online Calculator End User Agreement.

Estimate risk of perioperative myocardial infarction or cardiac arrest.

ASA Class
ASA 1 = Normal healthy patient
ASA 2 = Patients with mild systemic disease
ASA 3 = Patients with severe systemic disease
ASA 4 = Patients with severe systemic disease
that is a constant threat to life
ASA 5 = Moribund patients who are not expected
to survive without the operation
Preoperative Function

About this calculator

This risk calculator provides an estimate of perioperative cardiac risk for individual patients based on a model derived from a large sample (>400 000) of patients. This is intended to supplement the clinician’s own judgment and should not be taken as absolute. Certain limitations exist such as absence of information on preoperative stress test, echocardiography, arrhythmia, and aortic valve disease. Unfortunately, known/remote coronary artery disease (except prior PCI and cardiac surgery) was also not controlled for in the multivariate analysis. In spite of the absence of these variables, the predictive ability of the calculator as measured by c-statistic was 0.88 (88%), much higher than previous models such as Revised Cardiac Risk Index.

The details of the methodology are provided in the published paper.


Gupta PK, Gupta H, Sundaram A, Kaushik M, Fang X, Miller WJ, Esterbrooks DJ, Hunter CB, Pipinos II, Johanning JM, Lynch TG, Forse RA, Mohiuddin SM, Mooss AN. Development and validation of a risk calculator for prediction of cardiac risk after surgery. Circulation. 2011 Jul 26;124(4):381-7. Epub 2011 Jul 5.