Table 1 Risk scoring system (adapted from American College of Cardiology/American Heart Association guidelines)

High-risk surgery

   Gastrectomy

2

   Pancreatectomy

2

   Total colectomy

2

   Total esophagectomy

2

Other long surgical procedure associated with large-volume

fluid shift or blood loss

2

Intermediate-risk surgery

   Endarterectomy

1

   Head and neck

1

   Intraperitonial or intrathoracic

1

   Orthopedic

1

Clinical predictor

   Age > 60 years old

1

   Diabetes (defined as standard taking medication or not)

1

Abnormal electrocardiogram (left ventricular

hypertrophy, left bundle branch block, ST-T

abnormalities and atrial fibrillation)

1

Low functional capacity (inability to climb one flight of

stairs with a bag of groceries)

1

   Arrhythmia (receiving drug therapy)

1

   History of stroke

1

   Arterial hypertension (difficult to control)

1

Compensated or previous decompensated

heart failure (defined as standard)

1

Angina (Canadian Cardiovascular Society

classification system class I or II) or previous infarct or

Q waves, severe valvopathy (severe valvular regurgitation

with reduced left ventricular function)

1

   Chronic hepatic failure (defined as standard)

1

Chronic renal failure (preoperative creatinine > 2.0 mg/dl

or need for dialysis)

1

Chronic obstructive pulmonary disease (defined as standard)

or severe respiratory illness resulting in functional limitation

1