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RCRI
Predicts risk of major cardiac events (MI, pulmonary edema, VF, cardiac arrest, complete heart block) after non-cardiac surgery
Indication
- Predicts risk of major cardiac events (MI, pulmonary edema, VF, cardiac arrest, complete heart block) after non-cardiac surgery
Criteria
- id: high_risk_surgery; label: High-risk surgery (intraperitoneal, intrathoracic, suprainguinal vascular); type: yesno
- id: ihd; label: History of ischemic heart disease; type: yesno
- id: chf; label: History of congestive heart failure; type: yesno
- id: cvd; label: History of cerebrovascular disease (stroke or TIA); type: yesno
- id: insulin; label: Insulin-dependent diabetes mellitus; type: yesno
- id: creatinine; label: Preoperative creatinine > 2 mg/dL; type: yesno
Interpretation
- function(score) { if (score === 0) return { risk: '0 risk factors', tier: 'Very Low Risk', action: '3.9% risk of major cardiac event. Proceed with surgery.', color: 'green' }; if (score === 1) return { risk: '1 risk factor', tier: 'Low Risk', action: '6.0% risk. Proceed; consider perioperative beta-blocker if already on one.', color: 'green' }; if (score === 2) return { risk: '2 risk factors', tier: 'Moderate Risk', action: '10.1% risk. Consider further cardiac evaluation if poor functional capacity.', color: 'yellow' }; return { risk: score + ' risk factors', tier: 'High Risk', action: '15%+ risk. Cardiology consultation. Consider non-invasive cardiac testing.', color: 'red' }; }
Clinical pearls
- RCRI >= 2 with poor functional capacity (< 4 METs) warrants further evaluation
- Do NOT initiate beta-blockers on the day of surgery (POISE trial)
- Combine with functional capacity assessment for better risk stratification
Source and review
- Lee et al., Circulation 1999; Duceppe et al., Can J Cardiol 2017. Last reviewed: 2024-11-01