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Preoperative Assessment – Lee’s Revised Cardiac Risk Index (RCRI)

posted 2012-03-20, updated 2023-02-22

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Lee's Revised Cardiac Risk Index
Rule to determine the risk of complication following surgery.
[select name="Q1" value="false (0 points)=0|TRUE (1 point)=1"] <-- High Risk Surgery  [comment memo="High risk surgeries include: Emergency surgery (especially over age 75 years), cardiac procedures, aortic or other major vascular procedures, peripheral arterial vascular procedures, and prolonged surgery anticipated (>2 hours)"]
[select name="Q2" value="false (0 points)=0|TRUE (1 point)=1"] <-- Coronary Artery Disease [comment memo="History of myocardial infarction or positive exercise test; or current chest pain secondary to myocardial ischemia, current nitrate therapy, or electrocardiography with pathologic Q wave"]
[select name="Q3" value="false (0 points)=0|TRUE (1 point)=1"] <-- Congestive Heart Failure [comment memo="History of congestive heart failure, pulmonary edema, or paroxysmal nocturnal dyspnea; or current bilateral rales, S3 gallop, or chest radiography showing pulmonary vascular redistribution"]
[select name="Q4" value="false (0 points)=0|TRUE (1 point)=1"] <-- Cerebrovascular Disease [comment memo="History of cerebrovascular disease (e.g., transient ischemic attack, stroke)"]
[select name="Q5" value="false (0 points)=0|TRUE (1 point)=1"] <-- Diabetes Mellitus on Insulin
[select name="Q6" value="false (0 points)=0|TRUE (1 point)=1"] <-- Serum Creatinine >2 mg/dl
[calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)" memo="score"] out of 6 points.  [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6);score>2?'Risk Index Class IV, Major Cardiac Complication Risk >11.0%':score>1?'Risk Index Class III, Major Cardiac Complication Risk 6.6%':score>0?'Risk Index Class II, Major Cardiac Complication Risk 0.9%':'Risk Index Class I, Major Cardiac Complication Risk 0.4%'" memo="interpretation"]
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
references:
[link url="//www.ncbi.nlm.nih.gov/pubmed/10477528" memo="#1"] Lee (1999) Circulation 100: 1043-9.
[link url="//www.fpnotebook.com/cv/Surgery/LsRvsdCrdcRskIndx.htm" memo="#2"] Family Practice Notebook Page[/conditional]

Lee's Revised Cardiac Risk Index
Rule to determine the risk of complication following surgery.
<-- High Risk Surgery High risk surgeries include: Emergency surgery (especially over age 75 years), cardiac procedures, aortic or other major vascular procedures, peripheral arterial vascular procedures, and prolonged surgery anticipated (>2 hours)
<-- Coronary Artery Disease History of myocardial infarction or positive exercise test; or current chest pain secondary to myocardial ischemia, current nitrate therapy, or electrocardiography with pathologic Q wave
<-- Congestive Heart Failure History of congestive heart failure, pulmonary edema, or paroxysmal nocturnal dyspnea; or current bilateral rales, S3 gallop, or chest radiography showing pulmonary vascular redistribution
<-- Cerebrovascular Disease History of cerebrovascular disease (e.g., transient ischemic attack, stroke)
<-- Diabetes Mellitus on Insulin
<-- Serum Creatinine >2 mg/dl
scorescore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6) out of 6 points. interpretationscore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6);score>2?'Risk Index Class IV, Major Cardiac Complication Risk >11.0%':score>1?'Risk Index Class III, Major Cardiac Complication Risk 6.6%':score>0?'Risk Index Class II, Major Cardiac Complication Risk 0.9%':'Risk Index Class I, Major Cardiac Complication Risk 0.4%'
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