Gupta Perioperative Cardiac Risk Model

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Clinical Use

Provides a risk estimate of perioperative myocardial infarction or cardiac arrest

More Info

Gupta Perioperative Cardiac Risk Model was developed from a prospective database of patients undergoing surgery identified from the American College of Surgeons’ 2007 National Surgical Quality Improvement Program (NSQIP) database.

The database was used to determine risk factors associated with perioperative myocardial infarction or cardiac arrest (MICA). Among 257,385 patients included in the analysis, 0.65 percent developed perioperative MICA.

On multivariate logistic regression analysis, five factors were identified as predictors of MI or cardiac arrest:

  • Type of surgery
  • Dependent functional status
  • Abnormal creatinine
  • American Society of Anesthesiologists’ (ASA) class
  • Age

The risk model had a relatively high predictive accuracy (C statistic of 0.874) and outperformed the Revised cardiac risk index (RCRI) (C statistic of 0.747).

Detailed information regarding Gupta Perioperative Cardiac Risk Model methodology and risk calculator modeling can be found in the original article.


Risk Percentiles
Percentile Percent Risk
25th percentile 0.05%
50th percentile 0.14%
75th percentile 0.61%
90th percentile 1.47%
95th percentile 2.60%
99th percentile 7.69%

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1. Gupta PK, Gupta H, Sundaram A, et al. Development and validation of a risk calculator for prediction of cardiac risk after surgery. Circulation. 2011;124(4):381-7. Full text


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Developer: Sirikarn Napan, MD, FACC