RCRI

Q: Which of the following is NOT part of the Revised Cardiac Risk Index (RCRI) for pre-operative cardiac complications after noncardiac surgery? (select one)

A) Elevated-risk surgery

B) History of ischemic heart disease

C) History of liver insufficiency

D) History of cerebrovascular disease

E) Diabetes requiring insulin Rx

Answer: C

The revised Cardiac Risk Index for Pre-Operative Risk (RCRI) is created to estimate the risk of cardiac complications after noncardiac surgery. It consists of six parameters.

1. High-risk surgery such as intraperitoneal, intrathoracic, or supra-inguinal vascular surgeries

2. History of ischemic heart disease proven by previous history of myocardial infarction (MI); history of positive exercise test; history of angina requiring use of nitrate therapy or ECG with pathological Q waves

3. History of congestive heart failure (CHF) known by the history of pulmonary edema, bilateral rales, or S3 gallop; paroxysmal nocturnal dyspnea; chest x-ray (CXR) showing pulmonary vascular redistribution

4. History of cerebrovascular disease (CVA), either transient ischemic attack (TIA) or stroke

5. Diabetes Mellitus with pre-operative treatment with insulin

6. Pre-operative creatinine >2 mg/dL

Liver insufficiency is not a part of this calculator.

#surgical-critical-care

#cardiology

References:

1. Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, Sugarbaker DJ, Donaldson MC, Poss R, Ho KK, Ludwig LE, Pedan A, Goldman L. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999 Sep 7;100(10):1043-9. doi: 10.1161/01.cir.100.10.1043. PMID: 10477528.

2. Devereaux PJ, Goldman L, Cook DJ, Gilbert K, Leslie K, Guyatt GH. Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk. CMAJ. 2005 Sep 13;173(6):627-34. doi: 10.1503/cmaj.050011. PMID: 16157727; PMCID: PMC1197163.