modified Goldman cardiac risk index

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Introduction

Table

observation Points
age > 70 years 5
myocardial infarction -
< 6 months earlier 10
> 5 months earlier 5
angina -
class III (angina with 1-2 blocks normal walking) 10
class IV (angina with any activity) 20
alveolar pulmonary edema -
within 1 week 10
ever 5
critical aortic stenosis (suspected) 20
arrhythmias -
rhythm other than sinus rhythm or sinus + APC* 5
> 5 PVC/min 5
poor medical status - any of the following -
pO2 < 60 mm Hg, pCO2 > 50 mm Hg 5
serum K+ < 3.0 meq/L, BUN > 50 mg/dL -
creatinine > 3.0 mg/dL, bedridden -
emergency surgery 10

* atrial premature contractions (APC)

Scoring:

class risk
0-15 class 1 (< 5% risk of complications)
20-30 class 2 (27% risk of complications)
> 30 class 3 (60% risk of complications)
class risk
0-15 class 1 (< 5% risk of complications)
20-30 class 2 (27% risk of complications)
> 30 class 3 (60% risk of complications)

References

  1. Sepulveda GRECC guidelines
  2. Detsky et al J Gen Intern Med 1: 211-9, 1986