Gupta Risk Calculator
Assess perioperative cardiac risk (MICA) for surgical patients
Patient Assessment
Patient's age in years
Patient's ability to perform daily activities
American Society of Anesthesiologists physical status classification
Kidney function marker (Normal: ≤1.5 mg/dL or ≤133 µmol/L)
Select the primary surgical procedure
MICA Risk Assessment
Risk Percentile
Clinical Interpretation
Example Patient Case
Patient: Caroline, 76-year-old
Age: 76 years
Functional Status: Partially dependent (needs help with daily activities)
ASA Class: III (severe systemic disease)
Creatinine: 1.0 mg/dL (normal)
Surgery: Hip prosthesis (orthopedic)
Gupta Risk Calculation
Age: 76 × 0.02 = 1.52
Functional Status (Partial): +0.65
ASA Class III: -1.92
Creatinine (Normal): 0
Orthopedic Surgery: +0.8
x = 1.52 + 0.65 - 1.92 + 0 + 0.8 - 5.25 = -4.2
MICA Risk: 1.48% (High Risk, 90th-95th percentile)
Risk Stratification
Very Low/Low Risk
<0.14%
<50th percentile
Moderate Risk
0.14-1.47%
50th-90th percentile
High Risk
1.47-2.60%
90th-95th percentile
Very High Risk
>2.60%
>95th percentile
ASA Physical Status
Class I
Healthy patient, no systemic disease
Class II
Mild systemic disease
Class III
Severe systemic disease
Class IV
Life-threatening systemic disease
Class V
Moribund patient, not expected to survive
Clinical Applications
Preoperative risk assessment
Perioperative monitoring planning
Cardiology consultation guidance
Patient counseling and consent
Understanding the Gupta Risk Calculator
What is MICA?
MICA stands for Myocardial Infarction or Cardiac Arrest. The Gupta Risk Calculator assesses the probability of these serious cardiac events occurring during surgery or within 30 days after the procedure.
Clinical Validation
Based on the landmark study by Gupta et al., this calculator was developed and validated using data from over 400,000 surgical patients, making it a robust tool for perioperative cardiac risk assessment.
Key Risk Factors
Five Variables:
- • Age (continuous variable)
- • Functional status (independence level)
- • ASA physical status class
- • Serum creatinine level
- • Type of surgical procedure
Formula: Risk % = e^x / (1 + e^x), where x is calculated from the five weighted risk factors above.
Clinical Management by Risk Level
Low Risk (<0.14%)
Standard perioperative care. Routine monitoring may be sufficient.
Moderate Risk (0.14-1.47%)
Enhanced monitoring. Consider cardiology consultation for optimization.
High Risk (>1.47%)
Intensive monitoring, cardiology consultation, preoperative optimization, and specialized care planning.
Perioperative Interventions for High-Risk Patients
Preoperative Assessment
- • 12-lead ECG
- • Echocardiogram
- • Stress testing (if indicated)
- • Cardiology consultation
- • Optimization of medical therapy
Perioperative Monitoring
- • Continuous cardiac monitoring
- • Serial troponin measurements
- • Hemodynamic monitoring
- • Early mobilization protocols
- • Cardiology follow-up
Related Perioperative Risk Calculators
Important Medical Disclaimer
This Gupta Risk Calculator is designed for educational purposes and clinical reference only. It should never replace comprehensive preoperative assessment or professional medical judgment.
Healthcare professionals should:
- Use this calculator as part of comprehensive perioperative risk assessment
- Consider individual patient factors beyond the calculated risk score
- Follow current perioperative care guidelines (AHA/ACC, ASA)
- Ensure accurate data collection for reliable risk calculation
- Integrate findings with clinical judgment and multidisciplinary care planning
- Consider additional risk stratification tools when appropriate
This tool is based on the original Gupta et al. study and should be used in conjunction with current evidence-based guidelines for perioperative cardiac care and risk management.