1. What is the Modified Cardiac Risk Index?

The Modified Cardiac Risk Index (also known as Revised Cardiac Risk Index or RCRI) predicts the risk of major cardiac complications following non-cardiac surgery. It considers six independent risk factors to classify patients into four risk classes.

2. How Does the Calculator Work?

The calculator uses the Modified Cardiac Risk Index equation:

Where each positive factor adds 1 point to the total score:

• High-risk surgery (intraperitoneal, intrathoracic, or suprainguinal vascular procedures)
• History of ischemic heart disease (CAD)
• History of congestive heart failure (CHF)
• History of cerebrovascular disease (CVA or TIA)
• Preoperative insulin treatment for diabetes
• Preoperative serum creatinine >2.0 mg/dL

3. Importance of Cardiac Risk Assessment

Details: Preoperative cardiac risk assessment helps identify patients who may benefit from additional cardiac evaluation or perioperative management strategies to reduce cardiac complications.

4. Using the Calculator

Tips: Select "Yes" for each risk factor that applies to the patient. The calculator will sum the points and determine the risk class and estimated complication rate.

5. Frequently Asked Questions (FAQ)

Q1: What constitutes a high-risk surgery?
A: Intraperitoneal, intrathoracic, or suprainguinal vascular procedures are considered high-risk.

Q2: How accurate is this index?
A: The index has good discrimination (c-statistic ~0.75) for predicting major cardiac complications.

Q3: What are considered major cardiac complications?
A: Myocardial infarction, cardiac arrest, pulmonary edema, or complete heart block.

Q4: Should this be used for emergency surgery?
A: The index was validated for elective non-cardiac surgery. Use clinical judgment for emergency cases.

Q5: Are there newer risk indices available?
A: Yes, the NSQIP Surgical Risk Calculator incorporates more factors but is more complex to use.