Age >70 | Yes No |
MI within past 6 months | Yes No |
S3 gallop or JVD | Yes No |
Moderate to Severe AS | Yes No |
Non-NSR and/or PAC's on pre-op EKG | Yes No |
>5 PVC's per minute | Yes No |
Renal, hepatic, or ABG abnormality, or bedridden | Yes No |
Intraperitoneal, intrathoracic, or aortic surgery | Yes No |
Emergent surgery | Yes No |
SCORE:
0-5 = Class I. 99% will have no significant complication, 0.6% will have life-threatening complications, and 0.2% will have cardiac death.
6-12 = Class II. 96% no complication, 3% life-threatening, 1% cardiac death.
13-25 = Class III. 86% no complication, 11% life-threatening, 3% cardiac death.
>25 = Class IV. 49% no complication, 12% life-threatening, 39% cardiac death.
Notes: Detsky's modified algorithm may be more accurate. This index (Goldman) is the foundation of many other risk stratification indices.
Reference:
N Engl J Med 1977; 297: 845.
http://www.frca.co.uk/article.aspx?articleid=100187