Cardiac Risk, Modified (Detsky)
Info
Age >70 Yes No
MI more than 6 months ago Yes No
MI within past 6 months Yes No
Unstable Angina within 6 months Yes No
S3 gallop or JVD Yes No
Suspected Critical AS Yes No
Non-NSR and/or PAC's on pre-op EKG Yes No
>5 PVC's per minute (ever) Yes No
Renal, hepatic, or ABG abnormality, or bedridden Yes No
Emergent surgery Yes No
Pulmonary edema within past week Yes No
Any Hx of pulmonary edema Yes No
Class III Canadian Cardiovascular Society Angina Yes No
Class IV Canadian Cardiovascular Society Angina Yes No
R e s u l t s
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Score
 
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Info
Cardiac Risk, Modified (Detsky)

SCORE:
0-15 = Class I. Low Risk. Risk of cardiac complications including death from major surgery 0.42%. Risk from minor surgery 0.39%. Risk from all surgery 0.43%.
16-30 = Class II. Moderate Risk. Major surgery = 3.58%. Minor surgery = 2.75%. All surgery = 3.38%.
>30 = Class III. High Risk. Major Surgery = 14.93%. Minor surgery = 12.2%. All surgery = 10.6%.

 

Notes:

Class III CVS Angina is marked limitation of ordinary physical activity (1-2 blocks on level ground, or 1 flight of stairs).
Class IV CVS Angina is inability to perform any physical activity without Sx; Sx may occur at rest.

References:

  1. Detsky AS, Abrams HB, McLaughlin JR, et. al. Predicting cardiac complications in patients undergoing noncardiac surgery. J Gen Int Med. 1:211, 1986.
  2. Detsky AS, Abrams HB, Forbath N, et. al. Cardiac assessment for patients undergoing noncardiac surgery. Arch Intern Med. 146:2131, 1986.