Revised Cardiac Risk Index: Difference between revisions
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* high-risk surgery (intraperitoneal, intrathoracic, or vascular surgery above the inguinal ligaments). See [http://circ.ahajournals.org/cgi/content/full/100/10/1043/F1 prognosis by surgery type]. | * high-risk surgery (intraperitoneal, intrathoracic, or vascular surgery above the inguinal ligaments). See [http://circ.ahajournals.org/cgi/content/full/100/10/1043/F1 prognosis by surgery type]. | ||
* history of ischemic heart disease | * history of ischemic heart disease | ||
** Includes "history of myocardial infarction, history of a positive exercise test, current complaint of chest pain considered to be secondary to myocardial ischemia, use of nitrate therapy, or ECG with pathological Q waves" | |||
** Excludes: "patients with prior coronary revascularization procedures were categorized as having ischemic heart disease only if they had any of the other criteria" | |||
* history of congestive heart failure | * history of congestive heart failure | ||
* history of cerebrovascular disease | * history of cerebrovascular disease | ||
Revision as of 04:41, 31 July 2009
The Revised Cardiac Risk Index (RCRI) is a clinical prediction rule for use during preoperative care for prediction major cardiac complications of noncardiac surgery.[1] The original index was published in 1977.[2]
The component of the Index are:
- high-risk surgery (intraperitoneal, intrathoracic, or vascular surgery above the inguinal ligaments). See prognosis by surgery type.
- history of ischemic heart disease
- Includes "history of myocardial infarction, history of a positive exercise test, current complaint of chest pain considered to be secondary to myocardial ischemia, use of nitrate therapy, or ECG with pathological Q waves"
- Excludes: "patients with prior coronary revascularization procedures were categorized as having ischemic heart disease only if they had any of the other criteria"
- history of congestive heart failure
- history of cerebrovascular disease
- preoperative treatment with insulin
- preoperative serum creatinine >2.0 mg/dL
| Number of risk factors | Mortality | |
|---|---|---|
| Major cardiac complications (Original study)[1] |
Cardiovascular death (Independent validation)[3] | |
| ≥ 3 | 11% | 3.6% |
| 2 | 7% | 1.7% |
| 1 | 0.9% | 0.7% |
| 0 | 0.4% | 0.3% |
The RCRI has been validated among patients although exploratory analyses suggested that adding age and surgical details would improve the model.[3] The RCRI has been validated among patients undergoing surgery for peripheral arterial disease.[4]
References
- ↑ 1.0 1.1 Lee TH, Marcantonio ER, Mangione CM, et al (1999). "Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery". Circulation 100 (10): 1043–9. PMID 10477528. [e]
- ↑ Goldman L, Caldera DL, Nussbaum SR, et al (October 1977). "Multifactorial index of cardiac risk in noncardiac surgical procedures". N. Engl. J. Med. 297 (16): 845–50. PMID 904659. [e]
- ↑ 3.0 3.1 Boersma E, Kertai MD, Schouten O, et al. (October 2005). "Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index". Am. J. Med. 118 (10): 1134–41. DOI:10.1016/j.amjmed.2005.01.064. PMID 16194645. Research Blogging.
- ↑ Hoeks SE, op Reimer WJ, van Gestel YR, et al. (June 2009). "Preoperative cardiac risk index predicts long-term mortality and health status". Am. J. Med. 122 (6): 559–65. DOI:10.1016/j.amjmed.2008.10.041. PMID 19376487. Research Blogging.