Surgical: preoperative assessment
RCRI — Revised Cardiac Risk Index (Lee)
Counts six independent predictors of perioperative cardiac complications. Risks shown are the 30-day death, MI or cardiac arrest rates from the Canadian (CCS 2017) meta-analysis, with the original Lee estimates for comparison. Combine with functional capacity, biomarkers and the surgical risk category.
Upload a report, lab sheet or echo picture to fill this calculator automatically.
Criteria
Tap every item that applies
- Derived in 2893 patients aged ≥ 50 undergoing elective major non-cardiac surgery (Lee 1999). The original Lee estimates underestimate risk when troponin is measured routinely.
Total score
0
Class I · low risk
30-day death, MI or cardiac arrest ≈ 3.9% (Lee original 0.4%)
Decision guide
Proceed. ESC 2022: routine ECG, biomarkers and imaging are not needed in patients < 65 years without CVD or risk factors.
Ranges: 0 Class I · low risk1 Class II2 Class III3–6 Class IV · high risk
References
- 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. Circulation 1999;100:1043-1049.
- Duceppe E, et al. Canadian Cardiovascular Society guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery. Can J Cardiol 2017;33:17-32.
- Halvorsen S, et al. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery. Eur Heart J 2022;43:3826-3924.
More in Surgical: preoperative assessment