Revised Cardiac Risk Index: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Robert Badgett
(Added validation study)
imported>Robert Badgett
(Added table)
Line 10: Line 10:
* preoperative serum creatinine >2.0 mg/dL
* preoperative serum creatinine >2.0 mg/dL


The risk of major cardiac complications based on the number of risk factors are:
{| class="wikitable" align="right"
* 0 risk factor - 0.4%
|+ Mortality risk
* 1 risk factor - 0.9%
! rowspan="2"|Number of risk factors!! colspan="2"|Mortality
* 2 risk factor - 7%
|-
* 3 or more risk factors - 11%
! Original study<ref name="pmid10477528">{{cite journal |author=Lee TH, Marcantonio ER, Mangione CM, ''et al'' |title=Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery |journal=Circulation |volume=100 |issue=10 |pages=1043–9 |year=1999 |pmid=10477528 |doi= |issn=|url=http://circ.ahajournals.org/cgi/content/full/100/10/1043}}</ref> !! Independent validation<ref name="pmid16194645">{{cite journal |author=Boersma E, Kertai MD, Schouten O, ''et al.'' |title=Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index |journal=Am. J. Med. |volume=118 |issue=10 |pages=1134–41 |year=2005 |month=October |pmid=16194645 |doi=10.1016/j.amjmed.2005.01.064 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00170-1 |issn=}}</ref>
|-
| ≥ 3|| 11%|| 3.6%
|-
| 2|| 7%|| 1.7%
|-
| 1|| 0.9%|| 0.7%
|-
| 0|| 0.4%|| 0.3%
|}


The RCRI has been validated among patients although exploratory analyses suggested that adding age and surgical details would improve the model.<ref name="pmid16194645">{{cite journal |author=Boersma E, Kertai MD, Schouten O, ''et al.'' |title=Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index |journal=Am. J. Med. |volume=118 |issue=10 |pages=1134–41 |year=2005 |month=October |pmid=16194645 |doi=10.1016/j.amjmed.2005.01.064 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00170-1 |issn=}}</ref> The RCRI has been validated among patients undergoing surgery for [[peripheral arterial disease]].<ref name="pmid19376487">{{cite journal |author=Hoeks SE, op Reimer WJ, van Gestel YR, ''et al.'' |title=Preoperative cardiac risk index predicts long-term mortality and health status |journal=Am. J. Med. |volume=122 |issue=6 |pages=559–65 |year=2009 |month=June |pmid=19376487 |doi=10.1016/j.amjmed.2008.10.041 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00101-6 |issn=}}</ref>
The RCRI has been validated among patients although exploratory analyses suggested that adding age and surgical details would improve the model.<ref name="pmid16194645">{{cite journal |author=Boersma E, Kertai MD, Schouten O, ''et al.'' |title=Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index |journal=Am. J. Med. |volume=118 |issue=10 |pages=1134–41 |year=2005 |month=October |pmid=16194645 |doi=10.1016/j.amjmed.2005.01.064 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00170-1 |issn=}}</ref> The RCRI has been validated among patients undergoing surgery for [[peripheral arterial disease]].<ref name="pmid19376487">{{cite journal |author=Hoeks SE, op Reimer WJ, van Gestel YR, ''et al.'' |title=Preoperative cardiac risk index predicts long-term mortality and health status |journal=Am. J. Med. |volume=122 |issue=6 |pages=559–65 |year=2009 |month=June |pmid=19376487 |doi=10.1016/j.amjmed.2008.10.041 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00101-6 |issn=}}</ref>

Revision as of 01:02, 21 June 2009

This article is a stub and thus not approved.
Main Article
Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
This editable Main Article is under development and subject to a disclaimer.

The Revised Cardiac Risk Index (RCRI) is a clinical prediction rule for use during preoperative care for prediction major cardiac complications of noncardiac surgery.[1] The original index was published in 1977.[2]

The component of the Index are:

  • high-risk surgery (intraperitoneal, intrathoracic, or vascular surgery above the inguinal ligaments). See prognosis by surgery type.
  • history of ischemic heart disease
  • history of congestive heart failure
  • history of cerebrovascular disease
  • preoperative treatment with insulin
  • preoperative serum creatinine >2.0 mg/dL
Mortality risk
Number of risk factors Mortality
Original study[1] Independent validation[3]
≥ 3 11% 3.6%
2 7% 1.7%
1 0.9% 0.7%
0 0.4% 0.3%

The RCRI has been validated among patients although exploratory analyses suggested that adding age and surgical details would improve the model.[3] The RCRI has been validated among patients undergoing surgery for peripheral arterial disease.[4]

References

  1. 1.0 1.1 Lee TH, Marcantonio ER, Mangione CM, et al (1999). "Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery". Circulation 100 (10): 1043–9. PMID 10477528[e]
  2. Goldman L, Caldera DL, Nussbaum SR, et al (October 1977). "Multifactorial index of cardiac risk in noncardiac surgical procedures". N. Engl. J. Med. 297 (16): 845–50. PMID 904659[e]
  3. 3.0 3.1 Boersma E, Kertai MD, Schouten O, et al. (October 2005). "Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index". Am. J. Med. 118 (10): 1134–41. DOI:10.1016/j.amjmed.2005.01.064. PMID 16194645. Research Blogging.
  4. Hoeks SE, op Reimer WJ, van Gestel YR, et al. (June 2009). "Preoperative cardiac risk index predicts long-term mortality and health status". Am. J. Med. 122 (6): 559–65. DOI:10.1016/j.amjmed.2008.10.041. PMID 19376487. Research Blogging.