Revised Cardiac Risk Index (RCRI)
Check each risk factor present in the surgical candidate to estimate perioperative cardiac risk.
RCRI score
0
Risk class
Class I (Low risk)
≈0.4% risk of cardiac death, MI, or arrest
How to Use This Calculator
Gather preoperative data
Review medical history, lab results, and planned surgical procedure to identify RCRI criteria.
Check applicable risk factors
Each present criterion adds one point to the total score.
Use the risk class to guide management
Discuss expected perioperative cardiac risk and tailor medical optimization, monitoring, and postoperative disposition.
Formula
RCRI score = Sum of present risk factors (high-risk surgery, ischemic heart disease, heart failure, cerebrovascular disease, insulin-dependent diabetes, creatinine >2.0 mg/dL). Each factor = 1 point (0–6).
Full Description
The Revised Cardiac Risk Index predicts perioperative cardiac complications (death, myocardial infarction, cardiac arrest) after noncardiac surgery. It informs shared decision-making, postoperative monitoring intensity, and the need for further cardiac evaluation. Combine RCRI with functional capacity assessment and surgery-specific risk estimates to implement ACC/AHA perioperative guidelines.
Frequently Asked Questions
Does laparoscopic surgery count as high-risk?
Only intraperitoneal, intrathoracic, or suprainguinal vascular procedures qualify as high-risk operations.
How do I define ischemic heart disease?
Include prior MI, positive stress test, current chest pain suspected of ischemia, or the use of nitrate therapy.
Should beta-blockers be initiated based on RCRI?
Consider in patients with ≥3 risk factors undergoing high-risk surgery, consistent with guideline recommendations.
What if creatinine is measured in μmol/L?
Convert by dividing by 88.4; threshold corresponds to >176 μmol/L.