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

High-risk surgery (1 point)

Gastrectomy

Pancreatectomy

Total colectomy

Total esophagectomy

Another long surgical procedure associated with large fluid shifts or blood losses

Minor clinical predictor (1 point)

Diabetes (defined as standard taking medication or not)

Abnormal electrocardiogram (left ventricular hypertrophy, left bundle-branch block, ST-T abnormalities, atrial fibrillation)

Low functional capacity (inability to climb one flight of stairs with a bag of groceries)

Arrhythmia (using drugs)

History of stroke

Arterial hypertension (Difficult controlling).

Intermediate clinical predictor (2 points)

Age (>60 years)

Angina (class I or II, Canadian Cardiovascular Society Classification) or previous infarctus or Q waves

Compensated or previous decompensated heart failure (defined as standard)

Chronic hepatic failure (defined as standard)

Chronic renal failure (preoperative creatinine > 2.0 mg/dl or need for dialysis)

Chronic obstructive pulmonary disease (defined as standard) or severe respiratory illness resulting in functional limitation

Major clinical predictor (3 points)

Angina (class III or IV, Canadian Cardiovascular Society Classification) Severe arrhythmias (advanced heart block, ventricular arrhythmia in the presence of cardiopathy or supraventricular arrhythmia with tachycardia) Severe valvopathy (severe valvular regurgitation with reduced left ventricular function)