RCRI Calculator
Revised Cardiac Risk Index for perioperative cardiac risk assessment
Assess Perioperative Cardiac Risk
RCRI Assessment Results
Clinical Interpretation
Low risk of major cardiac complications within 30 days after noncardiac surgery. The risk of death, myocardial infarction, or cardiac arrest is 3.9%.
Clinical Significance
Example Case
High-Risk Patient
Patient: 72-year-old man scheduled for major abdominal surgery
Medical history: Previous stroke, diabetes on insulin, creatinine 2.3 mg/dL
Surgery type: Intraperitoneal (high-risk surgery)
RCRI Assessment
✓ Cerebrovascular disease (stroke): +1 point
✓ High creatinine (> 2 mg/dL): +1 point
✓ Insulin treatment: +1 point
✓ High-risk surgery: +1 point
Total RCRI Score: 4 (Class IV)
Risk: 15.0% for major cardiac complications
RCRI Risk Classes
30-day risk of death, MI, or cardiac arrest
Risk Factors Explained
Cardiovascular History
- • Prior stroke or TIA
- • Heart failure symptoms
- • Previous MI or ischemia
Medical Comorbidities
- • Kidney dysfunction
- • Insulin-dependent diabetes
Surgical Risk
- • Major abdominal surgery
- • Thoracic procedures
- • Vascular surgery
Perioperative Guidelines
Recommended Actions
- • Measure BNP/NT-proBNP (age ≥65 or RCRI ≥1)
- • Monitor troponin 48-72h post-op
- • Enhanced cardiac monitoring
Avoid Pre-operatively
- • Starting β-blockers <24h before surgery
- • New ACE inhibitors <24h before
- • Routine stress testing
- • Smoking
Understanding the Revised Cardiac Risk Index (RCRI)
What is RCRI?
The Revised Cardiac Risk Index (RCRI) is a validated clinical prediction tool developed by Lee et al. in 1999 to assess the risk of major cardiac complications following noncardiac surgery. It identifies six independent risk factors that are the strongest predictors of perioperative cardiac events.
Clinical Applications
- •Preoperative risk stratification
- •Informed consent discussions
- •Perioperative monitoring decisions
- •Cardiology consultation planning
Scoring System
Each risk factor = 1 point
Total possible score: 0-6 points
Validation
The RCRI has been extensively validated across diverse patient populations and surgical procedures. It provides excellent discrimination for identifying patients at highest risk for cardiac complications.
Important: RCRI is specifically designed for noncardiac surgery risk assessment and should be used in conjunction with clinical judgment and other risk assessment tools.
Medical Disclaimer
This RCRI calculator is intended for educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. The RCRI score should be interpreted by qualified healthcare professionals as part of a comprehensive preoperative assessment. Clinical decisions regarding perioperative management should always consider the complete clinical picture, patient-specific factors, and current medical guidelines. This tool does not replace clinical judgment or the need for appropriate medical evaluation and monitoring. Always consult qualified healthcare providers for medical decisions and perioperative care planning.