Vascular Surgery Cardiac Risk Index (VSG-CRI) Calculator

Vascular Surgery Cardiac Risk Index (VSG-CRI): Explanation and Clinical Context The VSG-CRI is a vascular-surgery–specific risk score developed from >10,000 patients undergoing carotid endarterectomy, lower-extremity bypass, endovascular AAA repair, and open AAA repair. It predicts in-hospital adverse cardiac events (myocardial infarction, arrhythmia, or decompensated heart failure) and was shown to outperform the Revised Cardiac Risk Index in this population. It assigns integer points to readily available preoperative variables: age (2 points for 60–69, 3 for 70–79, 4 for ≥80 years), coronary artery disease (+2), congestive heart failure (+2), COPD (+2), serum creatinine >1.8 mg/dL (+2), current smoking (+1), insulin-dependent diabetes (+1), chronic β-blocker therapy (+1), and subtracts 1 point for a history of coronary revascularization (CABG or PCI).

The summed score maps to six risk strata for adverse cardiac events: 0–3 (≈2.6%), 4 (≈3.5%), 5 (≈6.0%), 6 (≈6.6%), 7 (≈8.9%), and ≥8 (≈14.3%). These strata come from the original VSG-CRI derivation/validation cohorts and provide an intuitive perioperative estimate for counseling and planning. Procedure-specific logistic models (e.g., for CEA, LEB, EVAR, open AAA) were also reported and can further refine predictions, but the point-based aggregate VSG-CRI above mirrors the original published score for routine bedside use.

Contemporary analyses within the Vascular Quality Initiative confirmed clinical utility and suggested procedure-specific models improve accuracy for perioperative myocardial infarction; professional society guidelines acknowledge VSG-CRI as more accurate than RCRI in vascular surgery candidates.