Goldman Risk Index Calculator
Score
0
Revised Cardiac Risk Index (RCRI) and Goldman Index Calculator
Index used
Goldman multifactorial cardiac risk index (1977)
Risk class
Class I
Published event rate
0.9 %
95% confidence interval
Not published as an interval; these are the raw class proportions.
What "event" means here
Life-threatening cardiac complication or cardiac death: 4 + 1 of 537 Class I patients. Cardiac death alone was 0.2%.
Rate taken from
Goldman L et al., N Engl J Med 1977;297:845-850, Table 4
The other published rate for this score
0.2 %
Worked out from Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery and 2 other sources.
The Goldman index dates from 1977 and has been superseded by the RCRI in practice. It is offered here because the product is still asked for by name, not because it is the current standard.
A risk index, not a decision. Both indices were derived in specific surgical populations decades apart and neither includes functional capacity, the urgency of the operation as a continuous variable, or biomarker data. Perioperative management is a clinical judgement.
How this is worked out
3 steps
- No Goldman criterion is present, so the total is 0.
- Total 0 of a possible 53, which is Class I (0-5 points).
- In the 1977 cohort, 5 of 537 Class I patients had a life-threatening cardiac complication or died of a cardiac cause: 0.9%.
Criteriatable
| criterion | points | maximum | met |
|---|---|---|---|
| Third heart sound (S3 gallop) or jugular venous distension | 0 | 11 | No |
| Myocardial infarction in the previous 6 months | 0 | 10 | No |
| Rhythm other than sinus, or premature atrial contractions, on the last preoperative ECG | 0 | 7 | No |
| More than 5 premature ventricular contractions per minute at any time before surgery | 0 | 7 | No |
| Age over 70 years | 0 | 5 | No |
| Emergency operation | 0 | 4 | No |
| Intraperitoneal, intrathoracic or aortic operation | 0 | 3 | No |
| Important valvular aortic stenosis | 0 | 3 | No |
| Poor general medical status | 0 | 3 | No |
Results are general information, not financial, tax, legal, medical or engineering advice.