For Professionals · Calculators
Perioperative risk scores
Bedside calculators for cardiac and bleeding risk, VTE, frailty, renal function and liver severity. Pick a score, tick or enter the values, and the result updates live. Nothing stored.
RCRI (Lee)
Revised Cardiac Risk Index
30-day risk of major cardiac events after non-cardiac surgery. One point each.
Result
Score ≥ 1 with poor or unknown functional capacity (< 4 METs): the 2024 ACC/AHA pathway supports a resting BNP / NT-proBNP and, if elevated, further evaluation before major elective surgery.
Source: Lee 1999; 30-day estimates per CCS 2017.
CHA₂DS₂-VASc
AF stroke risk
Annual stroke risk in non-valvular atrial fibrillation → anticoagulation decision.
Result
Anticoagulate from ≥ 2 (men) / ≥ 3 (women). Female sex is a risk modifier, not a risk factor on its own. Perioperatively, weigh against bleeding and the procedure's timing.
Source: Lip 2010.
Caprini VTE
Caprini VTE Risk Score
Surgical VTE risk → prophylaxis intensity. Tick all that apply (age counts once).
Result
Pharmacologic prophylaxis is generally recommended from a score of 5 (considered at 3–4), balanced against bleeding risk and your unit's VTE policy.
Source: Caprini 2005.
Wells (DVT)
Wells Score — Deep Vein Thrombosis
Pre-test probability of a lower-limb DVT.
Result
Two-tier: ≥ 2 = 'DVT likely' → ultrasound; < 2 = 'unlikely' → a negative D-dimer reliably excludes it.
Source: Wells 2003.
Wells (PE)
Wells Score — Pulmonary Embolism
Pre-test probability of pulmonary embolism.
Result
Two-tier: ≤ 4 = 'PE unlikely' → D-dimer (or PERC); > 4 = 'PE likely' → CT pulmonary angiogram.
Source: Wells 2000.
HAS-BLED
Bleeding risk on anticoagulation
Major bleeding risk in AF on anticoagulation. One point each.
Result
A high score flags modifiable factors to correct (BP, labile INR, alcohol, concomitant antiplatelets) — it is not by itself a reason to withhold anticoagulation.
Source: Pisters 2010.
Clinical Frailty Scale
CFS (Rockwood)
Global frailty judgement from the fortnight before acute illness. Choose one level.
Result
CFS ≥ 5 is consistently associated with higher postoperative morbidity, mortality, delirium and loss of independence — trigger shared decision-making and a CGA where available.
Source: Rockwood Clinical Frailty Scale v2.0.
mFI-5
5-Item Modified Frailty Index
Quick comorbidity-based frailty index. One point each.
Result
Each additional point steps up the risk of complications, reoperation and 30-day mortality. A score ≥ 2 should prompt optimisation and a frank risk discussion.
Source: NSQIP-derived 5-item modified frailty index.
Creatinine clearance
Cockcroft-Gault CrCl
The reference for renal drug-dose adjustment — and the renal modifier for DOAC / neuraxial timing.
Result
Source: Cockcroft & Gault 1976.
eGFR (CKD-EPI 2021)
Race-free estimated GFR
CKD staging and screening (race-free). For drug dosing prefer creatinine clearance.
Result
Source: CKD-EPI 2021 (NKF / ASN, KDIGO).
Child-Pugh
Cirrhosis severity / operative risk
Cirrhosis severity and perioperative mortality. Class C → avoid elective surgery.
Result
Source: Pugh 1973.
MELD 3.0
Model for End-Stage Liver Disease
Liver-disease mortality and transplant priority (current OPTN). Higher = sicker.
Result
Source: OPTN MELD 3.0 (2023).
ECOG / WHO PS
ECOG performance status
Functional status & fitness for surgery in cancer. Oncology uses ECOG/Karnofsky (not ASA) for operative risk.
ECOG (0–5)
Why it matters perioperatively
Key sources
- Lee TH et al. RCRI, Circulation 1999; CCS 2017 estimates; 2024 ACC/AHA Perioperative Guideline.
- Lip GYH (CHA₂DS₂-VASc) 2010; Pisters (HAS-BLED) 2010.
- Caprini 2005; Wells DVT 2003 / PE 2000.
- Rockwood Clinical Frailty Scale; NSQIP 5-item modified frailty index.
- Cockcroft-Gault 1976; CKD-EPI 2021 (race-free); Child-Pugh 1973; OPTN MELD 3.0 (2023).
Calculators are decision support for adult patients and do not replace clinical assessment or your institutional pathways. Risk figures are population estimates. No data is stored.