Thompson A, Fleischmann KE. Smilowitz NR, et al. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2024. https://doi.org/10.1016/j.jacc.2024.06.013 [online ahead of print]

Halvorsen S, Mehilli J, Cassese S, Hall TS, Abdelhamid M, Barbato E, De Hert S, de Laval I, Geisler T, Hinterbuchner L, Ibanez B, Lenarczyk R, Mansmann UR, McGreavy P, Mueller C, Muneretto C, Niessner A, Potpara TS, Ristić A, Sade LE, Schirmer H, Schüpke S, Sillesen H, Skulstad H, Torracca L, Tutarel O, Van Der Meer P, Wojakowski W, Zacharowski K; ESC Scientific Document Group. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery. Eur Heart J. 2022 Oct 14;43(39):3826-3924. doi: 10.1093/eurheartj/ehac270. Erratum in: Eur Heart J. 2023 Nov 7;44(42):4421. doi: 10.1093/eurheartj/ehad577. PMID: 36017553.

Duceppe E, Parlow J, Macdonald P, et al. Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Can J Cardiol. 2017;33(1):17-32.

Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, Sugarbaker DJ, Donaldson MC, Poss R, Ho KK, Ludwig LE, Pedan A, Goldman L. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999 Sep 7;100(10):1043-9. PubMed PMID: 10477528.

Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, Burke DS, O'Malley TA, Goroll AH, Caplan CH, Nolan J, Carabello B, Slater EE. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977 Oct 20;297(16):845-50. PubMed PMID: 904659.

Rajagopalan S, Croal BL, Bachoo P, Hillis GS, Cuthbertson BH, Brittenden J. N-terminal pro B-type natriuretic peptide is an independent predictor of postoperative myocardial injury in patients undergoing major vascular surgery. J Vasc Surg. 2008;48(4):912-7.

Rodseth RN, Biccard BM, Le Manach Y, et al. The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and N-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual patient data meta-analysis. J Am Coll Cardiol. 2014;63(2):170-80.

Ford MK, Beattie WS, Wijeysundera DN. Systematic review: prediction of perioperative cardiac complications and mortality by the revised cardiac risk index. Ann Intern Med. 2010;152(1):26-35.

Fronczek J, Polok K, Devereaux PJ, Górka J, Archbold RA, Biccard B, Duceppe E, Le Manach Y, Sessler DI, Duchińska M, Szczeklik W. External validation of the Revised Cardiac Risk Index and National Surgical Quality Improvement Program Myocardial Infarction and Cardiac Arrest calculator in noncardiac vascular surgery. Br J Anaesth. 2019 Oct;123(4):421-429. doi: 10.1016/j.bja.2019.05.029. Epub 2019 Jun 27. PMID: 31256916.

Roshanov PS, Sessler DI, Chow CK, Garg AX, Walsh MW, Lam NN, Hildebrand AM, Biccard BM, Acedillo RR, MacNeil SD, Lee VW, Szczeklik W, Mrkobrada M, Thabane L, Devereaux PJ. Predicting Myocardial Injury and Other Cardiac Complications After Elective Noncardiac Surgery with the Revised Cardiac Risk Index: The VISION Study. Can J Cardiol. 2021 Aug;37(8):1215-1224. doi: 10.1016/j.cjca.2021.03.015. Epub 2021 Mar 23. PMID: 33766613.

Cohn SL, Fernandez Ros N. Comparison of 4 Cardiac Risk Calculators in Predicting Postoperative Cardiac Complications After Noncardiac Operations. Am J Cardiol. 2018 Jan 1;121(1):125-130. doi: 10.1016/j.amjcard.2017.09.031. Epub 2017 Oct 13. PMID: 29126584.

VISION Pilot Study investigators, Devereaux PJ, Bradley D, Chan MT, et al. An international prospective cohort study evaluating major vascular complications among patients undergoing noncardiac surgery: the VISION Pilot Study. Open Med. 2011;5(4):e193-200.

Ausset S, Auroy Y, Lambert E, et al. Cardiac troponin I release after hip surgery correlates with poor long-term cardiac outcome. Eur J Anaesthesiol. 2008;25(2):158-64.

Sheth T, Chan M, Butler C, et al. Prognostic capabilities of coronary computed tomographic angiography before non-cardiac surgery: prospective cohort study. BMJ. 2015;350:h1907.

Davis C, Tait G, Carroll J, Wijeysundera DN, Beattie WS. The Revised Cardiac Risk Index in the new millennium: a single-centre prospective cohort re-evaluation of the original variables in 9,519 consecutive elective surgical patients. Can J Anaesth. 2013 Sep;60(9):855-63. doi: 10.1007/s12630-013-9988-5. Epub 2013 Jun 28. PMID: 23813289.

Dr. Lee Goldman

Dr. Thomas H. Lee

Revised Cardiac Risk Index for Pre-Operative Risk

surgery

heart_disease

heart_failure

cerebrovasclar_disease

pre_op_insulin

pre_op_creatinine

Estimates risk of cardiac complications after noncardiac surgery.

Risk of major cardiac event from surgery.

Revised Cardiac Risk Index

The Revised Cardiac Risk Index for Pre-Operative Risk Estimates risk of cardiac complications after surgery.

Gupta Perioperative Risk

ACEF II Risk Score

Framingham Risk Score (Hard Coronary Heart Disease)

The American Academy of Pediatrics (AAP) focuses on the health, safety, and well-being of infants, children, and young adults. With about 67,000 members, including pediatricians, medical subspecialists, and surgical specialists, the AAP supports optimal care. Over 45,000 members are board-certified Fellows of the AAP (FAAP). Its mission is to promote children's health and well-being while supporting members' professional needs.

American Academy of Pediatrics (AAP)

The American Association for Physician Leadership&reg; (AAPL) is the world&rsquo;s oldest and largest professional association dedicated solely to maximizing physician leadership.&nbsp;From the moment physicians begin their leadership journey through the time they are seasoned leaders, AAPL provides education and training, resources and tools, and content and experiences needed to close gaps between hands-on clinical care, organization system improvements and optimized business outcomes.

American Association for Physician Leadership (AAPL)

American Association for the Study of Liver Diseases

The American College of Emergency Physicians (ACEP) represents more than 38,000 emergency physicians, emergency medicine residents and medical students. ACEP promotes the highest quality of emergency care and is the leading advocate for emergency physicians and their patients, and the public. Members may earn up to 850 continuing medical education hours every year through ACEP&rsquo;s robust catalog of peer-reviewed publications and on-demand courses presented by world-renowned emergency medicine experts.

American College Of Emergency Physicians

The American College of Gastroenterology (ACG) supports clinicians in delivering high-quality, evidence-based care to gastroenterology patients. Its mission is to advance care for those with gastrointestinal disorders through excellence, innovation, and advocacy. ACG provides members with up-to-date scientific information through annual meetings, the American Journal of Gastroenterology, training courses, and research grants, focusing on digestive health and GI disorder treatments.

American College of Gastroenterology

American College of Rheumatology

The American Gastroenterological Association (AGA), founded in 1897, provides leadership and education to over 16,000 members worldwide, all dedicated to advancing gastroenterology. The AGA&rsquo;s mission is to empower clinicians and researchers to improve digestive health through clinical guidance, practice resources, and peer-reviewed research. Key journals include Gastroenterology, Clinical Gastroenterology and Hepatology, Cellular and Molecular Gastroenterology and Hepatology, and others.

American Gastroenterological Association

American Heart Association

American Urological Association

EB Medicine is the premier provider of evidence-based clinical content and CME resources for emergency medicine practitioners.

EB Medicine

MDCalc CME

Postgraduate Institute for Medicine

The Rome Foundation is a nonprofit organization dedicated to advancing the diagnosis and treatment of Disorders of Gut-Brain Interaction (DGBI), also known as functional gastrointestinal disorders. Its mission is to improve the lives of people with DGBI. For over 30 years, the Rome Foundation has worked with scientists and clinicians worldwide to classify and assess GI function and dysfunction, creating symptom-based criteria used in clinical trials and daily practice to guide diagnosis and treatment.

The ROME Foundation

Listen to the VACO co-creators break down how to use VACO\, what it does\, and what it doesn’t.

Calc Function