Revised Cardiac Risk Index

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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
Outcomes
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. 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]
  2. 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. 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.
  4. 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.