🫀 Revised Cardiac Risk Index (RCRI / Lee)
Estimate peri-operative cardiac risk for noncardiac surgery with the Revised Cardiac Risk Index.
Clinical takeaway
More factors → higher major cardiac event risk.
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When to use
Pre-operative cardiac risk assessment.
How it works
1 point each: high-risk surgery, ischaemic heart disease, heart failure, cerebrovascular disease, insulin-dependent diabetes, creatinine > 2.0 mg/dL.
Key points
- More factors → higher major cardiac event risk.
- Newer cohorts give somewhat higher absolute risks.
- Combine with functional capacity and surgery-specific risk.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| High-risk surgery (intraperitoneal/thoracic/suprainguinal vascular) | No |
|---|---|
| Ischaemic heart disease | No |
| History of congestive heart failure | No |
| History of cerebrovascular disease | No |
| Insulin-dependent diabetes | No |
| Creatinine > 2.0 mg/dL | No |
→RCRI0
- Risk class：Class I — major cardiac event ~0.4% (original estimates)
- Use：≥ 1 factor and elevated surgical risk may prompt further cardiac evaluation/biomarkers.
| High-risk surgery (intraperitoneal/thoracic/suprainguinal vascular) | Yes (+1) |
|---|---|
| Ischaemic heart disease | Yes (+1) |
| History of congestive heart failure | Yes (+1) |
| History of cerebrovascular disease | Yes (+1) |
| Insulin-dependent diabetes | Yes (+1) |
| Creatinine > 2.0 mg/dL | Yes (+1) |
→RCRI6
- Risk class：Class IV — major cardiac event ~11% (original estimates)
- Use：≥ 1 factor and elevated surgical risk may prompt further cardiac evaluation/biomarkers.
Frequently asked questions
- What is Revised Cardiac Risk Index (RCRI / Lee)?
- Estimate peri-operative cardiac risk for noncardiac surgery with the Revised Cardiac Risk Index.
- How is Revised Cardiac Risk Index (RCRI / Lee) calculated? What is the core formula?
- 1 point each: high-risk surgery, ischaemic heart disease, heart failure, cerebrovascular disease, insulin-dependent diabetes, creatinine > 2.0 mg/dL.
- When is Revised Cardiac Risk Index (RCRI / Lee) used?
- Pre-operative cardiac risk assessment.
- What are the key clinical points for Revised Cardiac Risk Index (RCRI / Lee)?
- More factors → higher major cardiac event risk. Newer cohorts give somewhat higher absolute risks. Combine with functional capacity and surgery-specific risk.
- What are the limits and cautions when using Revised Cardiac Risk Index (RCRI / Lee)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Revised Cardiac Risk Index (RCRI / Lee) calculated in practice? Can you show a worked example?
- Inputs: High-risk surgery (intraperitoneal/thoracic/suprainguinal vascular) No, Ischaemic heart disease No, History of congestive heart failure No, History of cerebrovascular disease No, Insulin-dependent diabetes No, Creatinine > 2.0 mg/dL No → Result: RCRI 0（Risk class: Class I — major cardiac event ~0.4% (original estimates), Use: ≥ 1 factor and elevated surgical risk may prompt further cardiac evaluation/biomarkers.） Inputs: High-risk surgery (intraperitoneal/thoracic/suprainguinal vascular) Yes (+1), Ischaemic heart disease Yes (+1), History of congestive heart failure Yes (+1), History of cerebrovascular disease Yes (+1), Insulin-dependent diabetes Yes (+1), Creatinine > 2.0 mg/dL Yes (+1) → Result: RCRI 6（Risk class: Class IV — major cardiac event ~11% (original estimates), Use: ≥ 1 factor and elevated surgical risk may prompt further cardiac evaluation/biomarkers.）