Perioperative Cardiac Risk Calculator
Perioperative Myocardial Infarction or Cardiac Arrest (MICA)
This tool supports clinical judgment and does not replace it.
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Estimates the risk of myocardial infarction or cardiac arrest during surgery or within 30 days after it.
Limits of this model
This model was built on 2007 NSQIP data and validated on 2008 data. It predates routine troponin surveillance after surgery.
It counted a myocardial infarction only with qualifying ECG changes, or a new troponin above 3 times the upper reference limit with suspected myocardial ischemia. It does not estimate troponin-only myocardial injury found by routine postoperative screening.
About this model
- Built from 211,410 patients in the 2007 American College of Surgeons National Surgical Quality Improvement Program (NSQIP), and validated on 257,385 patients in the 2008 data.
- 1,371 patients (0.65%) had the outcome in the 2007 data.
- C statistic 0.884 in 2007 and 0.874 in 2008. Among the 26,183 patients in the 2008 data having aortic or noncardiac vascular surgery, it was 0.746.
How estimates were distributed in the original spreadsheet
| Percentile | Percent risk |
|---|---|
| 25th | 0.05% |
| 50th | 0.14% |
| 75th | 0.61% |
| 90th | 1.47% |
| 95th | 2.60% |
| 99th | 7.69% |
Citation
Gupta PK, Gupta H, Sundaram A, Kaushik M, Fang X, Miller WJ, Esterbrooks DJ, Hunter CB, Pipinos II, Johanning JM, Lynch TG, Forse RA, Mohiuddin SM, Mooss AN. Development and validation of a risk calculator for prediction of cardiac risk after surgery. Circulation. 2011;124(4):381-7. doi:10.1161/CIRCULATIONAHA.110.015701 · PubMed 21730309
Original spreadsheet
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