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Cardiac Risk Index in Noncardiac Surgery (Goldman, et. al.)


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)

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)

Emergency (4 points)

Intraperitoneal, intrathoracic or aortic (3 points)

Total Criteria Point Count:


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


  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 Logo
  2. Internet Site: ACP Clinical Guideline Resource,

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

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