Saturday 15 December 2012

Goldman Cardiac Risk Index in Non Cardiac Surgery

Criteria
Points
Goldman Classification Total Points

Class I    0-5 points      1% complications

Class II   6-12 points    7% complications

Class III  13-25 points 14% complications

Class IV  >25 points    78% complications

History
·         Age > 70 y
·         Myocardial infarction within 6 months

5
10
Physical examination
·         S3 gallop or jugular venous distention
·         Significant aortic stenosis

11
3
Electrocardiogram
·         Rhythm other than sinus or
premature atrial contractions
·         > 5 PVC’s per minute

7

7
Poor general medical status
PO2 < 60 or PCO2 > 50 or K< 3.0 or HCO3 < 20 or BUN >17.8 or 
Creatinine > 3, elevated SGOT or
Chronic liver disease or
Bedridden for noncardiac causes
3
Operation
·         Intraperitoneal, intrathoracic, or aortic procedure
·         Emergency surgery

3

4

References:
1.     Goldman L, Caldera DL, Nussbaum SR, et. al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N. Engl J Med. 297:845, 1977



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