Detsky Modified Cardiac Risk Index Calculator

Detsky Modified Cardiac Risk Index for preoperative cardiac risk in non-cardiac surgery.

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.

Myocardial infarction

Canadian Cardiovascular Society angina

Unstable angina within 3 months

Pulmonary edema

Suspected critical aortic stenosis

Rhythm other than sinus, or sinus plus atrial premature beats on last ECG

> 5 premature ventricular beats/min at any time before surgery

Poor general medical status

Age > 70 years

Emergency operation

Score

—

Interpretation

—

References

Detsky AS, Abrams HB, McLaughlin JR, et al. Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med. 1986;1(4):211-219.

How to use

Select each cardiac and perioperative factor for the patient.
The weighted total and Detsky risk class update instantly.
Combine with surgery-specific risk for the full ACP perioperative estimate.

Frequently asked questions

What is the Detsky Modified Cardiac Risk Index?

A modification of the Goldman index adding angina class and unstable angina, used as the preoperative cardiac risk component in older ACP guidelines.

How are Detsky classes defined?

Class I ≤ 15 points (low risk), Class II 20–30 (intermediate), Class III > 30 (high risk).

How was Detsky used clinically?

It was combined with surgery-specific risk and likelihood ratios in the ACP perioperative algorithm to estimate post-test probability of cardiac complications.

Detsky vs RCRI?

The Lee RCRI is simpler and now preferred for routine use; Detsky retains value where angina severity is a prominent factor.

Last updated June 28, 2026