Postoperative Stroke Risk Model (Noncardiac Surgery) Calculator

Age (years)

ASA Physical Status

Emergency surgery

History of stroke/TIA

Coronary artery disease

Myocardial infarction within 6 months

Dialysis

Acute renal failure (preop)

Hypertension

COPD

Current smoker

BMI (kg/m²)

Preop sodium

Creatinine > 1.8 mg/dL

Hematocrit ≤ 27%

Surgery type

Postoperative Stroke Risk Model: Explanation and Clinical Context
This calculator estimates 30-day postoperative ischemic stroke risk after noncardiac, nonneurologic surgery using preoperative variables. Predictors are derived from NSQIP-based studies and include age, prior stroke/TIA, coronary disease, recent myocardial infarction, renal dysfunction, anemia, dysnatremia, COPD, hypertension, smoking, ASA class, emergency status, and surgical category.

Stroke incidence after noncardiac surgery is typically 0.1–1%, but risk concentrates among older patients, those with cerebrovascular or renal disease, and in high-risk surgeries such as vascular or thoracic. This model uses an evidence-informed scoring system reflecting those predictors, mapped to an estimated absolute risk via a logistic function.

References:
Mashour GA, Shanks AM, Kheterpal S. Anesthesiology. 2011;114(6):1289–1296. doi:10.1097/ALN.0b013e318216e7f4.
Woo SH, et al. J Am Heart Assoc. 2021;10(4):e018013. doi:10.1161/JAHA.120.018013.

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