⚕ Goldman Cardiac Risk Index
Goldman Risk Index Calculator
Pre-operative cardiac risk assessment tool for patients undergoing major non-cardiac surgery. Based on the validated Goldman Cardiac Risk Index.
⚕️ For use by licensed medical professionals only. Not a substitute for clinical judgment or formal pre-operative evaluation.
// goldman_cardiac_risk_index()
Goldman Cardiac Risk Index
The Goldman Cardiac Risk Index (1977, updated by Detsky 1986) is one of the most widely validated pre-operative cardiac risk assessment tools. It uses 9 weighted clinical variables to classify patients into four risk classes before major non-cardiac surgery.
| Class | Points | Major Cardiac Event | Cardiac Death | Risk Level |
|---|---|---|---|---|
| Class I | 0–5 | ~0.7% | ~0.2% | Very Low |
| Class II | 6–12 | ~5% | ~2% | Low-Moderate |
| Class III | 13–25 | ~11% | ~2% | Moderate-High |
| Class IV | ≥26 | ~22% | ~56% | Very High |
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FAQ
The Goldman Cardiac Risk Index is used by anaesthesiologists and internists during pre-operative evaluation to quantify the risk of major cardiac events (cardiac death, non-fatal MI, or pulmonary oedema) in patients scheduled for major non-cardiac surgery. It guides decisions about additional cardiac workup, peri-operative monitoring intensity, and whether surgical risk is acceptable.
The Goldman index remains clinically relevant but has been largely supplemented by the Revised Cardiac Risk Index (RCRI/Lee Index, 1999), which is simpler (6 factors) and better validated in contemporary surgical populations. The ACC/AHA guidelines now primarily use the RCRI for stepwise pre-operative assessment. Goldman remains useful for educational understanding of cardiac risk factors.