Surgery

Revised Cardiac Risk Index

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Revised Cardiac Risk Index, Goldman Index, Goldman Cardiac Risk Index, Lee's Revised Cardiac Risk Index, Revised Cardiac Index

  • Criteria
  1. High Risk Surgery (Cardiac Risk >5%): 1 Point
  2. Coronary Artery Disease: 1 Point
    1. Myocardial Infarction history
    2. Positive Exercise Stress Test
    3. Chest Pain secondary to Myocardial Infarction
    4. Current use of nitrates to control Angina
    5. Pathologic Q Waves on EKG
  3. Congestive Heart Failure: 1 Point
    1. Pulmonary Edema
    2. Paroxysmal nocturnal Dyspnea
    3. Bibasilar rales
    4. S3 Gallup Rhythm
    5. Chest XRay demonstrating pulmonary vascular congestion
  4. Cerebrovascular Disease (TIA or CVA): 1 Point
  5. Diabetes Mellitus on Insulin: 1 Point
  6. Serum Creatinine >2.0 mg/dl: 1 Point
  • Interpretation
  1. Scoring
    1. Points 0: Class I Very Low (0.4% complications)
    2. Points 1: Class II Low (0.9% complications)
    3. Points 2: Class III Moderate (6.6% complications)
    4. Points 3: Class IV High (>11% complications)
  2. Complications predicted by above scoring
    1. Myocardial Infarction
    2. Pulmonary Embolism
    3. Ventricular Fibrillation
    4. Cardiac Arrest
    5. Complete Heart Block
  • References
  1. Lee (1999) Circulation 100:1043-9 [PubMed]