Revised Cardiac Risk Index (Lee)
Revised Cardiac Risk Index (Lee) - a deterministic tool in Sophie Well's Clinical Scoring & Risk group.
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What this is
Score the Revised Cardiac Risk Index (Lee) for predicting major perioperative cardiac events after non-cardiac surgery. Check the six binary factors that apply to your patient - high-risk surgery type (intraperitoneal, intrathoracic, suprainguinal vascular), ischemic heart disease, congestive heart failure, cerebrovascular disease, insulin-treated diabetes, and a preoperative creatinine >2 mg/dL. Sophie Well totals the points and reports the Lee class with its associated cardiac-event risk band. Source: Lee TH et al. Circulation 1999;100:1043-1049.
When to use it
Use this during the preoperative cardiac assessment for a patient undergoing elective non-cardiac surgery to quantify their baseline 30-day risk of cardiac death, non-fatal MI, or non-fatal cardiac arrest. RCRI is one of the two scores (with NSQIP-MICA) embedded in the 2014 ACC/AHA perioperative algorithm and gates the decision to obtain functional-capacity assessment or non-invasive cardiac testing. It is calibrated for stable elective surgery, not for emergency or trauma operations, and does not replace clinical judgment about an unstable cardiac patient who needs medical optimization before any incision.
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(10):1043-1049.
Worked example: RCRI 2 factors -> ~6.6% major cardiac event risk (Class III per Lee 1999).
Sophie Well is a reference and educational tool. Not medical, legal, or financial advice. Does not replace clinician judgment, professional billing review, or legal counsel.