TolOpCito
Kalkulator skoring perioperatif
Tanggal & Identitas Singkat
Timing of Surgery
Immediate: tanpa penundaan untuk menyelamatkan nyawa/fungsi organ. Urgent: tanpa penundaan yang tidak perlu untuk nyawa/anggota gerak/fungsi organ. Time-sensitive: sesegera mungkin karena risiko time-dependent. Elective: dapat dikerjakan terencana.
Cardiac Condition
Unstable: mis. unstable angina, acute heart failure, aritmia signifikan, penyakit katup simptomatik, atau infark miokard baru. Active: butuh evaluasi/tatalaksana kardiologi sebelum operasi non-urgent. No active: tidak ada kondisi jantung aktif bermakna saat ini.
Surgical Risk
Low surgical risk (<1%)
Intermediate surgical risk (1-5%)
High surgical risk (>5%)
Klasifikasi broad estimate risiko 30 hari kejadian kardiovaskular (kematian kardiovaskular, infark miokard, stroke) menurut tipe prosedur.
METS (Functional Capacity)
≥4 METs kira-kira mampu naik 1–2 lantai tangga / jalan cepat. <4 METs bila aktivitas ringan saja sudah terbatas.
RCRI (Revised Cardiac Risk Index)
History of ischaemic heart disease
Riwayat infark miokard, tes latihan (exercise test) positif, nyeri dada saat ini karena iskemia miokard, penggunaan terapi nitrat, atau EKG dengan gelombang Q patologis.
History of congestive heart failure
Edema paru, rales bilateral atau S3 gallop, paroxysmal nocturnal dyspnoea (PND), atau foto toraks (CXR) menunjukkan redistribusi vaskular paru.
Elevated-risk surgery
Intraperitoneal, Intratoraks, atau Vaskular supra-inguinal.
History of cerebrovascular disease
Riwayat transient ischaemic attack (TIA) atau stroke sebelumnya.
Pre-operative treatment with insulin
Pre-operative creatinine > 2 mg/dL / 176.8 µmol/L
Risiko Major Cardiac Event: Skor 0 (3.9%), 1 (6.0%), 2 (10.1%), ≥3 (15%).
Geriatric-Sensitive Perioperative Cardiac Risk Index (GSCRI)
Riwayat Stroke / CVA
Riwayat Heart Failure (CHF)
Model memakai rumus regresi logistik: e^x/(1+e^x) dengan x = Σ(poin) − 6.79.
Gupta Postoperative Risk
Riwayat COPD
Emergency (Cito)
Merokok ≤1 thn
ARISCAT Score
(Data usia dan status Emergency ditarik otomatis dari isian di atas).
Respiratory infection in last month
Preop anemia (Hgb ≤10 g/dL)
Gupta Pneumonia Risk: -
Gupta Resp. Failure Risk: -
ARISCAT Score: -
PADUA Prediction Score (VTE risk — medis rawat inap)
Active cancer
Previous VTE (exclude superficial VT)
Reduced mobility ≥3 hari (bed rest)
Known thrombophilia
Trauma/surgery ≤1 bulan
Usia ≥70 tahun
Heart and/or respiratory failure
Acute MI atau ischemic stroke
Acute infection / rheumatologic
Obesity (BMI ≥30)
Ongoing hormonal treatment
Skor ≥4 = risiko tinggi VTE.
CAPRINI Score (VTE risk — pasien bedah)
Recent History (< 1 month)
+1History of prior major surgery
+1Congestive heart failure
+1Sepsis
+1Serious lung disease incl. pneumonia
+1Acute myocardial infarction
+5Stroke
+5Multiple trauma
+5Acute spinal cord injury (paralysis)
+5Hip, pelvis, or leg fracture
Other Conditions
+1Swollen legs (current)
+1Varicose veins
+1Obesity (BMI ≥25)
+2Central venous access
+2Malignancy (present or previous)
+1Inflammatory bowel disease
+1Abnormal pulmonary function (COPD)
+3History of DVT/PE
+3Family history of thrombosis
+3Positive Factor V Leiden
+3Positive prothrombin 20210A
+3Elevated serum homocysteine
+3Positive lupus anticoagulant
+3Elevated anticardiolipin antibodies
+3Heparin-induced thrombocytopenia (HIT)
+3Other congenital or acquired thrombophilia
Interpretasi (umum): 0 very low, 1–2 low, 3–4 moderate, ≥5 high — sesuai tabel rekomendasi profilaksis.
IMPROVE Bleeding Risk Score
Faktor Klinis
+4.5Active gastroduodenal ulcer
+4.0Bleeding in 3 months prior to admission
+4.0Platelet count <50 × 10⁹ cells/L
+2.5Hepatic failure (INR >1.5)
+2.5ICU/CCU stay
+2.0Central venous catheter
+2.0Rheumatic disease
+2.0Current cancer
Interpretasi umum: skor <7 = low bleeding risk, ≥7 = high bleeding risk.
Marcantonio Prediction Rule (1994)
Estimasi risiko delirium pascaoperasi pada pasien geriatri yang menjalani pembedahan nonkardiak
Umur ≥ 70 tahun (1)
Riwayat penyalahgunaan alkohol (1)
Gangguan kognitif baseline (1)
Gangguan fisik berat (1)
Kadar elektrolit / glukosa abnormal (1)
Pembedahan toraks nonkardiak (1)
Pembedahan aneurisma aorta (2)
Risiko Delirium Pasca Operasi berdasarkan poin (0: 2%, 1–2: 11%, ≥3: 50%).
Rekap hasil untuk disalin
Klik Hitung Skor. Hasil akan muncul di bawah.
Referensi:
RCRI (Lee, 1999), GSCRI (Gupta, 2011), Pneumonia & Respiratory Failure Risk (Gupta, 2011), ARISCAT (Canet, 2010), PADUA Score (Barbar, 2010), Caprini Score (2005), IMPROVE Bleeding (Decousus, 2011), dan Marcantonio Delirium Risk (1994).