Cardiovascular Medicine Book

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Detsky's Modified Cardiac Risk Index

Aka: Detsky's Modified Cardiac Risk Index
  1. Indications
    1. ACP Preoperative Cardiac Risk Assessment
  2. Risk Factors: Patient
    1. Age older than 70 years: 5 points
    2. Prior Myocardial Infarction
      1. Last infarction within 6 months: 10 points
      2. Last infarction more than 6 months ago: 5 points
    3. Unstable Angina within last 6 months: 10 points
    4. Angina Pectoris
      1. Canadian Angina Class 3: 10 points
      2. Canadian Angina Class 4: 20 points
    5. Alveolar pulmonary edema
      1. Pulmonary edema within one week: 10 points
      2. Pulmonary edema at any time: 5 points
    6. Suspected critical Aortic Stenosis: 20 points
    7. Arrhythmia
      1. Rhythm other than sinus or sinus with PACs: 5 points
      2. More than five premature ventricular beats: 5 points
    8. Emergency surgery: 10 points
    9. Poor general medical status: 5 points
      1. Based on Goldman Risk Index
  3. Interpretation
    1. Class 1: Points 0-15 (Low risk)
    2. Class 2: Points 20-30 (Moderate risk)
    3. Class 3: Points >30 (High risk)
  4. References
    1. Detsky (1986) J Gen Intern Med 1:213 [PubMed]

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