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November 1986

Cardiac Assessment for Patients Undergoing Noncardiac Surgery A Multifactorial Clinical Risk Index

Author Affiliations

From the Departments of Health Administration (Dr Detsky) and Medicine (Drs Detsky, Abrams, Forbath, Scott, and Hilliard), University of Toronto, and the Division of General Internal Medicine and Clinical Epidemiology, Toronto General Hospital (Drs Detsky, Abrams, Forbath, Scott, and Hilliard).

Arch Intern Med. 1986;146(11):2131-2134. doi:10.1001/archinte.1986.00360230047007

• In this article, we describe a multifactorial cardiac risk index that can be used to assess patients undergoing noncardiac surgery. The index is a modified version of an index that was previously generated by Goldman and coworkers on a set of 1001 consecutive patients and prospectively validated in our clinical setting (a general medical consultation service in a large teaching hospital) on 455 patients. We present a Bayesian approach to assessing cardiac risks by converting average risks for patients undergoing particular surgical procedures (pretest probabilities) to average risks for patients with each index score (posttest probabilities). A simple nomogram is presented for performing such a calculation.

(Arch Intern Med 1986;146:2131-2134)