Guidelines
ACC/ESC-aligned perioperative cardiovascular risk assessment framework.
How to use this page
Use the calculator for patient-specific PERICARE-ML estimates and guideline-based scores. This page summarizes the clinical logic that should be considered alongside the numeric output.
Initial assessment
- Define urgency of surgery and do not delay emergency procedures for low-yield testing.
- Screen for active cardiac symptoms, established cardiovascular disease, renal dysfunction, diabetes, and poor functional capacity.
- Use surgical risk category together with patient factors rather than interpreting model output alone.
Guideline-based scores
- AUB-HAS2 and RCRI are displayed as clinical comparators alongside PERICARE-ML estimates.
- AUB-HAS2 incorporates age, hemoglobin, emergency surgery, vascular surgery, angina or dyspnea, and heart disease history.
- RCRI incorporates high-risk surgery, ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, and creatinine >2 mg/dL.
Testing and consultation
- Additional ECG, biomarker, echo, stress imaging, or cardiology consultation decisions should follow ACC/ESC perioperative pathways.
- For low-risk surgery or low calculated risk without unstable symptoms, routine cardiac testing is usually not indicated.
- For high-risk surgery or elevated clinical risk, testing should be considered only when it may change perioperative management.