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The Derivation and Validation of a Geriatric-Sensitive Perioperative Cardiac Risk Index (GSCRI)


Surgical patients age 65 and over face a high risk of cardiac complications. The Revised Cardiac Risk Index (RCRI) and the Gupta Myocardial Infarction or Cardiac Arrest (MICA) are widely used to predict perioperative cardiac risk but they are not specifically designed to predict that risk in geriatric patients. The objective of this study is to develop and validate a geriatric-sensitive cardiac risk index (GSCRI). Three variables were selected using Lasso regression in the National Surgical Quality Improvement Program (NSQIP) 2013 with the addition of four clinically significant variables. The model was developed using the NSQIP 2013 geriatric cohort (N=485,426) (172,905 age ≥ 65) and validated on the NSQIP 2012 geriatric cohort (N=485,426) (210,914 age ≥ 65). The Area under the Curve (AUC) for the NSQIP 2012 geriatric cohort for three indices was compared. Gupta MICA had an AUC of 0.70 and the RCRI had an AUC of 0.63. Our GSCRI model showed better performance with an AUC of 0.76

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