Gupta risk calculator (MICA) estimates a patient’s probability of perioperative myocardial infarction or cardiac arrest within 30 days of non-cardiac surgery using a validated NSQIP-derived logistic model. It’s faster and often more discriminative than legacy scores (e.g., RCRI) when you have the five inputs: age, ASA class, functional status, creatinine (>1.5 mg/dL threshold), and procedure category.

Use the tool below to get an instant probability and a clear risk band mapped to guideline thresholds (e.g., “low risk” <1% MACE).

Gupta MICA Risk Calculator

Gupta Risk Calculator

Predicts 30-day risk of myocardial infarction or cardiac arrest (MICA).

MICA risk: — %
Disclaimer
This calculator is provided for educational and informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease, nor should it be used as a substitute for professional medical advice, clinical judgment, or institutional protocols. Clinical decisions should be based on a comprehensive evaluation of the patient, including history, physical examination, laboratory data, and imaging, and should be made by a qualified healthcare professional. Use of this tool is at the user’s own risk, and the developers assume no responsibility for clinical outcomes resulting from its use.

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What is the Gupta risk calculator (MICA)?

The Gupta risk calculator (also called NSQIP MICA) predicts the probability of myocardial infarction or cardiac arrest within 30 days after non-cardiac surgery. It was derived and validated on hundreds of thousands of NSQIP cases and published in Circulation (2011). In head-to-head analysis, its predictive performance surpassed RCRI.

The five inputs it needs

  • Age (years)
  • Functional status (independent, partially dependent, totally dependent)
  • ASA class (I–V)
  • Creatinine (binary threshold: > 1.5 mg/dL adds risk)
  • Procedure category (21 site groups; e.g., aortic, brain, intestinal, orthopedic, vein, etc.)
Gupta Risk calculator infographic showing the Gupta cardiac risk formula using e^x / (1 + e^x), including age, functional status, ASA class, creatinine, and procedure coefficients, with low, moderate, and high cardiac risk categories.

The math (kept transparent)

Logistic form: risk = e^x / (1 + e^x) where
x = 0.02 × Age + Functional + ASA + Creatinine(+0.61 if >1.5) + Procedure − 5.25.
Those coefficients match the original publication and widely used community implementations.

How to interpret the number

  • < 1% → often treated as “low risk” (procedures with MACE <1% are “low risk” in ACC/AHA 2014).
  • 1–2.6% → intermediate zone (between the guideline’s low-risk cut and the ~95th percentile of NSQIP MICA).
  • ≥ 2.6% → higher relative risk (≥ ~95th percentile in the reference distribution).

Guideline context: Perioperative guidance was updated in 2024 (AHA/ACC et al.). Use clinical judgment, biomarkers, and team-based decision-making instead of fixating on a single score.

Why clinicians still use it

  • Parsimonious: 5 routinely available items, no imaging required.
  • Performance: Original work reported better discrimination than RCRI; multiple external studies continue to explore its utility across specific surgeries. Translation: it’s pragmatic when you need a probability fast.

Where our calculator is different (your page’s value prop)

  • Immediate, readable output with the raw logit x and exact formula shown for auditability.
  • Evidence-tied bands (Low / Moderate / Higher) aligned with guideline thresholds and NSQIP percentiles instead of arbitrary colors.
  • Quality-of-life features: reset button, keyboard support, and inline Sources + Disclaimer so nobody mistakes probability for a decision.
    (That transparency beats black-box widgets and improves trust with faculty, trainees, and clinicians.)

Step-by-step: using the calculator correctly

  1. Enter Age (years).
  2. Select Functional status accurately don’t over-call “independent.”
  3. Pick the correct ASA class from the pre-op note.
  4. Type Creatinine (use the latest value; threshold is >1.5 mg/dL).
  5. Choose the Procedure category closest to the planned operation.
  6. Click Calculate → read % risk and the risk band. If the number challenges your plan, escalate per local policy (pre-op optimization, cardiology consult, biomarkers, etc.).

Limitations (don’t ignore these)

  • Calibration drift: Models trained on one era/system can mis-estimate absolute risk elsewhere; recalibration may be needed.
  • Not a decision rule: ACC/AHA stress team-based judgment; the model supplements decisions, it doesn’t make them.
  • Procedure coding matters: Picking the wrong category skews risk.
  • Population fit: Some subspecialty cohorts show variable performance; check local data where possible.

FAQ

No. NSQIP/ACS has a broader calculator for multiple outcomes; Gupta MICA targets MI or cardiac arrest with 5 variables.

ACC/AHA 2014 uses <1% MACE to define low-risk procedures; anything ≥1% is elevated risk and may warrant more evaluation depending on context.

Yes. The 2024 AHA/ACC update emphasizes a stepwise approach, better use of biomarkers, and shared decision-making. Don’t use any calculator in isolation.

The 2011 Circulation paper by Gupta et al. describes development and validation on NSQIP data.

References

Gupta PK et al., Circulation 2011 (MICA model).
ACC/AHA 2014 perioperative guideline (defines <1% “low risk”).
AHA/ACC 2024 perioperative update (modern stepwise approach).
OmniCalculator (community coefficient table/implementation).
Evidencio (percentile distribution of MICA risk).
PubMed abstract noting MICA outperforms RCRI in original work; recent specialty-cohort validations.

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