Revised Cardiac Risk Index Calculator
Score
0
Revised Cardiac Risk Index (RCRI) and Goldman Index Calculator
Index used
Revised Cardiac Risk Index (Lee 1999)
Risk class
Class I
Published event rate
3.9 %
95% confidence interval
2.8-5.4%
What "event" means here
30-day major adverse cardiac event, including troponin-detected myocardial injury, which is why these rates run far above the 1999 figures.
Rate taken from
Canadian Cardiovascular Society 2017 pooled estimate (24 studies, n = 792,740)
The other published rate for this score
0.4 %
Worked out from Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery and 2 other sources.
The two published rate tables differ several-fold at low scores because they count different outcomes. Quote whichever your setting uses, and say which it is.
A risk index, not a decision. Both indices were derived in specific surgical populations decades apart and neither includes functional capacity, the urgency of the operation as a continuous variable, or biomarker data. Perioperative management is a clinical judgement.
How this is worked out
4 steps
- None of the six Lee predictors is present.
- Score = 0, i.e. Class I.
- Canadian Cardiovascular Society 2017 pooled estimate (24 studies, n = 792,740): 3.9% (95% CI 2.8-5.4%).
- For comparison, Lee 1999 prospective validation cohort (n = 1,422) gives 0.4% for the same score.
Criteriatable
| criterion | points | maximum | met |
|---|---|---|---|
| High-risk surgery | 0 | 1 | No |
| History of ischaemic heart disease | 0 | 1 | No |
| History of congestive heart failure | 0 | 1 | No |
| History of cerebrovascular disease (stroke or TIA) | 0 | 1 | No |
| Preoperative insulin treatment for diabetes | 0 | 1 | No |
| Preoperative serum creatinine above 2.0 mg/dL (177 µmol/L) | 0 | 1 | No |
Results are general information, not financial, tax, legal, medical or engineering advice.