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Revised Cardiac Risk Index (RCRI) for pre-operative risk
Estimates risk of a major cardiac complication after non-cardiac surgery.
Revised Cardiac Risk Index (RCRI) for pre-operative risk
High-risk surgery (intraperitoneal, intrathoracic, or suprainguinal vascular)
History of ischaemic heart disease
History of congestive heart failure
History of cerebrovascular disease (stroke or TIA)
Insulin-treated diabetes mellitus
Preoperative creatinine >2.0 mg/dL (177 umol/L)
Result0 points
Class I: estimated risk of a major cardiac event about 0.4 %.
- Risk of major cardiac event
- 0.4 %
When to use
- Estimating cardiac risk before elective non-cardiac surgery to guide further cardiac testing and perioperative management.
Formula
One point each for: high-risk surgery, ischaemic heart disease, congestive heart failure, cerebrovascular disease, insulin-treated diabetes, and creatinine >2.0 mg/dL. Score 0 = class I, 1 = class II, 2 = class III, >=3 = class IV.
Pearls and pitfalls
- Derived and validated in patients undergoing elective major non-cardiac surgery; original rates of major cardiac complication were 0.4 %, 0.9 %, 6.6 %, and 11 % for classes I-IV.