🫀 Gupta Perioperative Cardiac Risk MICA (framework)
The Gupta Perioperative Cardiac Risk (MICA) model predicts the probability of 30-day postoperative myocardial infarction or cardiac arrest using five preoperative factors and a procedure-specific logistic regression. This page frames the inputs and threshold and links to the official calculator.
Because per-procedure coefficients dominate the result and are numerous, this tool deliberately lists the five inputs and a threshold rather than outputting an invented probability. (original synthesis · not guideline verbatim)
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When to use
Use in preoperative cardiac risk assessment, alongside RCRI and functional capacity, to decide whether further cardiac testing is warranted. A predicted risk ≥ 1% commonly triggers additional evaluation.
How it works
x = 0.02×age + functional-status coefficient + ASA coefficient + creatinine coefficient + procedure coefficient − 5.25; risk = eˣ/(1+eˣ). The −5.25 intercept and 0.02 age coefficient are published; per-procedure coefficients are numerous, so use the official calculator for the precise value.
Key points
- Because per-procedure coefficients dominate the result and are numerous, this tool deliberately lists the five inputs and a threshold rather than outputting an invented probability. (original synthesis · not guideline verbatim)
- The five inputs are age, ASA class, functional status, serum creatinine > 1.5 mg/dL, and procedure category.
- Published examples span ~0.08% (low-risk young ASA II) to ~30% (elderly ASA V dependent, pancreaticoduodenectomy), illustrating how procedure weight drives risk.
References
- Gupta PK, et al. Development and Validation of a Risk Calculator for Prediction of Cardiac Risk After Surgery. Circulation 2011 (C-statistic 0.88).
- MDCalc — Gupta Perioperative Cardiac Risk.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | 65 yr |
|---|---|
| ASA class | I |
| Functional status | Independent |
| Serum creatinine > 1.5 mg/dL (> 133 μmol/L) | No/normal |
| Procedure category (e.g. aortic/brain/peripheral vascular/pancreaticoduodenal) | Low-risk (e.g. breast/endocrine/superficial) |
→Gupta MICAReference framework (use official calculator)
- Nature：Gupta MICA uses logistic regression to convert 5 preoperative factors into a 30-day MI/cardiac-arrest probability; the model contains per-procedure coefficients (high-risk procedures such as aortic carry far greater weight than e.g. breast). The per-procedure coefficients are numerous, so to avoid fabricating a precise probability this tool lists the required 5 items and provides the official calculator; it does not output a computed result
- Model structure：x = 0.02×age + functional-status coefficient + ASA coefficient + creatinine coefficient + procedure coefficient − 5.25; risk = eˣ/(1+eˣ). Intercept −5.25 and age coefficient 0.02 are published; for the remaining coefficients (especially per-procedure) defer to the official source
- Threshold：A predicted risk ≥ 1% is generally used as the trigger threshold for further cardiac evaluation (combined with RCRI, functional capacity, guidelines)
Frequently asked questions
- What is Gupta Perioperative Cardiac Risk MICA (framework)?
- The Gupta Perioperative Cardiac Risk (MICA) model predicts the probability of 30-day postoperative myocardial infarction or cardiac arrest using five preoperative factors and a procedure-specific logistic regression. This page frames the inputs and threshold and links to the official calculator.
- How is Gupta Perioperative Cardiac Risk MICA (framework) calculated? What is the core formula?
- x = 0.02×age + functional-status coefficient + ASA coefficient + creatinine coefficient + procedure coefficient − 5.25; risk = eˣ/(1+eˣ). The −5.25 intercept and 0.02 age coefficient are published; per-procedure coefficients are numerous, so use the official calculator for the precise value.
- When is Gupta Perioperative Cardiac Risk MICA (framework) used?
- Use in preoperative cardiac risk assessment, alongside RCRI and functional capacity, to decide whether further cardiac testing is warranted. A predicted risk ≥ 1% commonly triggers additional evaluation.
- What are the key clinical points for Gupta Perioperative Cardiac Risk MICA (framework)?
- Because per-procedure coefficients dominate the result and are numerous, this tool deliberately lists the five inputs and a threshold rather than outputting an invented probability. (original synthesis · not guideline verbatim) The five inputs are age, ASA class, functional status, serum creatinine > 1.5 mg/dL, and procedure category. Published examples span ~0.08% (low-risk young ASA II) to ~30% (elderly ASA V dependent, pancreaticoduodenectomy), illustrating how procedure weight drives risk.
- What are the limits and cautions when using Gupta Perioperative Cardiac Risk MICA (framework)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Gupta Perioperative Cardiac Risk MICA (framework) calculated in practice? Can you show a worked example?
- Inputs: Age 65 yr, ASA class I, Functional status Independent, Serum creatinine > 1.5 mg/dL (> 133 μmol/L) No/normal, Procedure category (e.g. aortic/brain/peripheral vascular/pancreaticoduodenal) Low-risk (e.g. breast/endocrine/superficial) → Result: Gupta MICA Reference framework (use official calculator)（Nature: Gupta MICA uses logistic regression to convert 5 preoperative factors into a 30-day MI/cardiac-arrest probability; the model contains per-procedure coefficients (high-risk procedures such as aortic carry far greater weight than e.g. breast). The per-procedure coefficients are numerous, so to avoid fabricating a precise probability this tool lists the required 5 items and provides the official calculator; it does not output a computed result, Model structure: x = 0.02×age + functional-status coefficient + ASA coefficient + creatinine coefficient + procedure coefficient − 5.25; risk = eˣ/(1+eˣ). Intercept −5.25 and age coefficient 0.02 are published; for the remaining coefficients (especially per-procedure) defer to the official source, Threshold: A predicted risk ≥ 1% is generally used as the trigger threshold for further cardiac evaluation (combined with RCRI, functional capacity, guidelines)）