🫀 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.
Gupta Perioperative Cardiac Risk MICA (framework)
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.