Revised Cardiac Risk Index: Difference between revisions
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imported>Robert Badgett (Added validation study) |
imported>Robert Badgett (Added table) |
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* preoperative serum creatinine >2.0 mg/dL | * preoperative serum creatinine >2.0 mg/dL | ||
{| class="wikitable" align="right" | |||
|+ Mortality risk | |||
! rowspan="2"|Number of risk factors!! colspan="2"|Mortality | |||
|- | |||
! Original study<ref name="pmid10477528">{{cite journal |author=Lee TH, Marcantonio ER, Mangione CM, ''et al'' |title=Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery |journal=Circulation |volume=100 |issue=10 |pages=1043–9 |year=1999 |pmid=10477528 |doi= |issn=|url=http://circ.ahajournals.org/cgi/content/full/100/10/1043}}</ref> !! Independent validation<ref name="pmid16194645">{{cite journal |author=Boersma E, Kertai MD, Schouten O, ''et al.'' |title=Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index |journal=Am. J. Med. |volume=118 |issue=10 |pages=1134–41 |year=2005 |month=October |pmid=16194645 |doi=10.1016/j.amjmed.2005.01.064 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00170-1 |issn=}}</ref> | |||
|- | |||
| ≥ 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.<ref name="pmid16194645">{{cite journal |author=Boersma E, Kertai MD, Schouten O, ''et al.'' |title=Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index |journal=Am. J. Med. |volume=118 |issue=10 |pages=1134–41 |year=2005 |month=October |pmid=16194645 |doi=10.1016/j.amjmed.2005.01.064 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00170-1 |issn=}}</ref> The RCRI has been validated among patients undergoing surgery for [[peripheral arterial disease]].<ref name="pmid19376487">{{cite journal |author=Hoeks SE, op Reimer WJ, van Gestel YR, ''et al.'' |title=Preoperative cardiac risk index predicts long-term mortality and health status |journal=Am. J. Med. |volume=122 |issue=6 |pages=559–65 |year=2009 |month=June |pmid=19376487 |doi=10.1016/j.amjmed.2008.10.041 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00101-6 |issn=}}</ref> | The RCRI has been validated among patients although exploratory analyses suggested that adding age and surgical details would improve the model.<ref name="pmid16194645">{{cite journal |author=Boersma E, Kertai MD, Schouten O, ''et al.'' |title=Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index |journal=Am. J. Med. |volume=118 |issue=10 |pages=1134–41 |year=2005 |month=October |pmid=16194645 |doi=10.1016/j.amjmed.2005.01.064 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00170-1 |issn=}}</ref> The RCRI has been validated among patients undergoing surgery for [[peripheral arterial disease]].<ref name="pmid19376487">{{cite journal |author=Hoeks SE, op Reimer WJ, van Gestel YR, ''et al.'' |title=Preoperative cardiac risk index predicts long-term mortality and health status |journal=Am. J. Med. |volume=122 |issue=6 |pages=559–65 |year=2009 |month=June |pmid=19376487 |doi=10.1016/j.amjmed.2008.10.041 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00101-6 |issn=}}</ref> | ||
Revision as of 00:02, 21 June 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
- 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 | |
|---|---|---|
| Original study[1] | 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.