ASA PS (1963)1010 ASA Physical Status Classification System [Internet]. [citado 05 de julho de 2021]. Disponível em: https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system https://www.asahq.org/standards-and-guid...
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Simple and fast application. Good for identifying low-risk patients |
Not developed for risk assessment and performs worse in high-risk situations |
ACS NSQIP Calculator (2013)1111 Bilimoria KY, Liu Y, Paruch JL, Zhou L, Kmiecik TE, Ko CY, et al. Development and Evaluation of the Universal ACS NSQIP Surgical Risk Calculator: A Decision Aid and Informed Consent Tool for Patients and Surgeons. J Am Coll Surg. 2013;217(5):833-842.e3. doi: 10.1016/j.jamcollsurg.2013.07.385. https://doi.org/10.1016/j.jamcollsurg.20...
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Evaluates 9 outcomes, assesses 21 variables, almost all clinical |
Risk assessment is better for death, renal failure, and cardiac complications than other outcomes |
Goldman - CRI (1977)1818 Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977;297(16):845-50. doi: 10.1056/NEJM197710202971601. https://doi.org/10.1056/NEJM197710202971...
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Simple application |
Low performance in aortic operations. There are newer models with similar ratings. |
Detsky (1986)2222 Detsky AS, Abrams HB, McLaughlin JR, Drucker DJ, Sasson Z, Johnston N, et al. Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med. 1986;1(4):211-9. doi: 10.1007/BF02596184. https://doi.org/10.1007/BF02596184...
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Simple application. Adaptation of the CRI that included more types of operations and outcomes |
There are newer models with similar ratings. |
RCRI (1999)2424 Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and Prospective Validation of a Simple Index for Prediction of Cardiac Risk of Major Noncardiac Surgery. Circulation. 1999;100(10):1043-9. doi: 10.1161/01.cir.100.10.1043. https://doi.org/10.1161/01.cir.100.10.10...
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Simple application. Latest adaptation of the CRI. Recommended by Brazilian, American, and European risk assessment guidelines |
Does not include some clinically important factors (age, functional tolerance, aortic stenosis). Not a good predictor of non-cardiac mortality. Limited performance for vascular operations. |
Fleisher-Eagle (2001)3333 Fleisher LA. Clinical practice. Lowering cardiac risk in noncardiac surgery. 2001;345(23):1677-82. doi: 10.1056/NEJMcp002842. https://doi.org/10.1056/NEJMcp002842...
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Simple application recommendation algorithm |
No validation study |
EMAPO (2007)3434 Pinho C, Grandini PC, Gualandro DM, Calderaro D, Monachini M, Caramelli B. Multicenter study of perioperative evaluation for noncardiac surgeries in Brazil (EMAPO). Clinics. 2007;62(1):17-22. doi: 10.1590/s1807-59322007000100004. https://doi.org/10.1590/s1807-5932200700...
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Validated for the Brazilian population, recommended by the SBC risk assessment guideline |
Complex application |
MICA Calculator (2011)3535 Gupta PK, Gupta H, Sundaram A, Kaushik M, Fang X, Miller WJ, et al. Development and Validation of a Risk Calculator for Prediction of Cardiac Risk After Surgery. Circulation. 26 de julho de 2011;124(4):381-7. doi: 10.1161/CIRCULATIONAHA.110.015701. https://doi.org/10.1161/CIRCULATIONAHA.1...
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Includes functional status in the assessment. Recommended by American and European guidelines |
Does not consider preoperative heart failure. Limited performance for vascular operations. |
POSSUM (1991)3838 Copeland GP, Jones D, Walters M. POSSUM: A scoring system for surgical audit. Br J Surg. 1991;78(3):355-60. doi: 10.1002/bjs.1800780327. https://doi.org/10.1002/bjs.1800780327...
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Developed for application in auditing and quality of care |
Complex application. Not validated for clinical application |
VSG-CRI (2010)4545 Bertges DJ, Goodney PP, Zhao Y, Schanzer A, Nolan BW, Likosky DS, et al. The Vascular Study Group of New England Cardiac Risk Index (VSG-CRI) predicts cardiac complications more accurately than the Revised Cardiac Risk Index in vascular surgery patients. J Vasc Surg. 2010;52(3):674-683.e3. doi: 10.1016/j.jvs.2010.03.031. https://doi.org/10.1016/j.jvs.2010.03.03...
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Developed specifically for vascular operations |
Risk assessment for endovascular repair of abdominal aortic aneurysm (EVAR) |
Model for Stroke and Cardiac Risk After Surgery (2021)4949 Woo SH, Marhefka GD, Cowan SW, Ackermann L. Development and Validation of a Prediction Model for Stroke, Cardiac, and Mortality Risk After Non-Cardiac Surgery. J Am Heart Assoc. 2021;10(4):e018013. doi: 10.1161/JAHA.120.018013. https://doi.org/10.1161/JAHA.120.018013...
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Assesses outcomes in 30 days. Includes stroke. Uses variables subject to pre-surgical clinical adjustment |
Does not consider atrial fibrillation. Does not consider time in the history of cerebrovascular disease. |