This is a multi-factorial index of cardiac risk in the non-cardiac surgical setting. It was developed for preoperative identification of patients at risk from major perioperative cardiovascular complications. The data were derived retrospectively in 1977 from 1001 patients undergoing non-cardiac surgery.
Goldman Cardiac Risk factors
Nine independent risk factors are evaluated on a point scale:
 Third heart sound (S3) 11
Elevated jugulovenous pressure 11
Myocardial infarction in past 6 months 10
ECG: premature arterial contractions or any rhythm other than sinus 7
ECG shows >5 premature ventricular contractions per minute 7
Age >70 years 5
Emergency procedure 4
Intra-thoracic, intra-abdominal or aortic surgery 3
Poor general status, metabolic or bedridden 3
Patients with scores >25 had a 56% incidence of death, with a 22% incidence of severe cardiovascular complications.
Patients with scores <26 had a 4% incidence of death, with a 17% incidence of severe cardiovascular complications.
Patients with scores <6 had a 0.2% incidence of death, with a 0.7% incidence of severe cardiovascular complications.
[LB Goldman (Boston Cardiologist)]
Reference
Multifactorial index of cardiac risk in noncardiac surgical procedures
Goldman L, Caldera DL, Nussbaum SR
N Engl J Med 1977; 297: 845-50
ArticleDate:20041207
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