Gupta Perioperative Cardiac Risk MICA (framework) — free guideline decision tool

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.

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.

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.

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.

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.

Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.

Inputs: Age 65 yr, ASA class III, Functional status Partially dependent, Serum creatinine > 1.5 mg/dL (> 133 μmol/L) Yes/elevated, Procedure category (e.g. aortic/brain/peripheral vascular/pancreaticoduodenal) Intermediate (e.g. abdominal/orthopedic/urologic) → 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)）