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Gupta Perioperative Risk for Myocardial Infarction or Cardiac Arrest (MICA)

Predicted probability of MI or cardiac arrest within 30 days of non-cardiac surgery.

Gupta Perioperative Risk for Myocardial Infarction or Cardiac Arrest (MICA)
Age
years
Functional status
ASA physical status class
Preoperative creatinine >1.5 mg/dL
Procedure type
Complete the fields above to see the result.

When to use

  • Preoperative risk discussion and shared decision-making before non-cardiac surgery.

Formula

Logistic model: x = 0.02 x age + functional-status coefficient + ASA-class coefficient + creatinine coefficient + procedure coefficient - 5.25; risk (%) = e^x / (1 + e^x) x 100.

Pearls and pitfalls

  • Derived from >200,000 patients in the American College of Surgeons NSQIP database.
  • Procedure-type coefficients are the strongest driver of risk; aortic and cardiac surgery carry the highest added risk.

References

  1. Gupta PK, Gupta H, Sundaram A, et al. Circulation. 2011;124(4):381-7.