Revised Cardiac Risk Index

How to use it

1. 1

   Identify surgery type. High-risk: intraperitoneal (bowel), intrathoracic, or supra-inguinal vascular (aorta). Peripheral, ENT, orthopaedic = not high-risk.

2. 2

   Review medical history. IHD, CCF, stroke/TIA, insulin-dependent DM, CKD stage 3b+ (Cr >177 µmol/L).

3. 3

   Score ≥2. Consider echocardiography or cardiology review before elective major surgery.

When to use it

Preoperative cardiac assessment

Standard tool in pre-op clinics for non-cardiac surgery.

Optimisation before elective surgery

Score ≥2: ensure beta-blocker, statin, antiplatelet optimised. Consider stress testing if unknown functional capacity.

Emergency surgery

Proceeds regardless of RCRI; risk communicated to patient and surgical team.