Gupta score

This Gupta risk calculator functions as a cardiac arrest and myocardial infarction risk calculator, as well as determining a person’s individual need for closer cardiac monitoring.

Gupta perioperative risk calculator serves as a tool for calculating a patient’s risk of a cardiac event – defined here as Myocardial Infarction or Cardiac Arrest (MICA).

It applies to patients in the perioperative period, that is during surgery or 30 days after it.

The tool takes into consideration the general well-being of the patient, their age, kidney function and how difficult the surgery is. 

It does not take into account some myocardial infarction risk factors, such as LDL levels or smoking status, which are critical in estimating cardiovascular disease risk.

The result helps identify those patients who need their cardiac functions monitored more carefully by physicians and nurses.

Those at low risk don’t need any additional cardiac tests after surgery, as their result is below 50% of the population.

Gupta risk calculator

The formula for determining the risk of myocardial infarction or cardiac arrest is:

cardiac risk [%] = ex / (1 + ex),

where: x = age * 0.02 + status + asa + creatinine + type – 5.25,

so, x depends on five variables: 

Age in years, multiplied by 0.02

Status of a patient:

Totally independent (0)

Partially dependent (0.65)

Totally independent (1.03)

ASA Class

Class 1: healthy (-5.17)

Class 2: mild systemic disease (-3.29)

Class 3: severe systemic disease (-1.92)

Class 4: a severe systemic disease that puts a patient’s life at risk of death (-0.95)

Class 5: moribund, not expected to survive without surgery (0)

Creatinine levels

Normal (≤1.5 mg/dL, 133 µmol/L (0)

Elevated (>1.5 mg/dL, 133 µmol/L (0.61)

Type of surgery

Hernia: ventral, inguinal, femoral, and other (0)

Anorectal: anus and rectum (-0.16)

Aortic (1.6)

Bariatric (-0.25)

Brain (1.4)

Breast (-1.61)

Cardiac: Heart (1.01)

ENT, except thyroid and parathyroid (0.71)

Foregut/hepato-pancreaticobiliary: esophagus, stomach, duodenum, pancreas, liver, and biliary tree (except isolated cholecystectomy) (1.39)

Gallbladder, appendix, adrenals, spleen, biliary tree surgeries other than cholecystectomy not included (0.59)

Intestinal, below the level of the duodenum (1.14)

Neck, including thyroid and parathyroid (0.18)

Obstetric or gynecologic (0.76)

Orthopedic (0.8)

Abdomen, other (1.13)

Peripheral vascular, nonaortic, nonvein vascular surgeries (0.86)

Skin (0.54)

Spine (0.21)

Thoracic, except esophageal and cardiac (0.4)

Vein (-1.09)

Urology, kidneys and urinary system (-0.26)

Patients at a high risk of myocardial infarction or cardiac arrest present a Gupta score above 1%. 

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