Revised cardiac risk index

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Criteria

  • High-risk surgery (vascular surgery, open intraperitoneal surgery, or intrathoracic surgery
  • History of ischemic heart disease, including history of MI, positive exercise test, current angina, use of nitrate therapy, ECG with pathological Q waves; does not include prior coronary revascularization procedures in and of themselves
  • History of heart failure
  • History of cerebrovascular disease
  • Diabetes mellitus requiring insulin
  • Preoperative creatinine greater than 177

Interpretation

Points Risk of death, MI, or cardiac arrest (old) Risk of MI, pulmonary edema, VF, cardiac arrest, and complete heart block (old) Risk of death, MI, or cardiac arrest (new)1
0 0.4% 0.5% 3.9%
1 1% 1.3% 6%
2 2.5% 3.6% 10.1%
3+ 5.4% 9.1% 15%

References

  1. ^  Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I. Sessler, Gregory Bryson, P.J. Devereaux. Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Canadian Journal of Cardiology. 2017;33(1):17-32. doi:10.1016/j.cjca.2016.09.008.