1. What is the Modified Cardiac Risk Index?

The Modified Cardiac Risk Index (also known as Revised Cardiac Risk Index or RCRI) is a clinical prediction tool used to assess the risk of major cardiac complications following non-cardiac surgery. It was developed and modified by researchers at the Mayo Clinic.

2. How Does the Calculator Work?

The calculator uses the Modified Cardiac Risk Index equation:

Where each risk factor counts as 1 point:

• 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)
• Insulin-dependent diabetes mellitus
• Preoperative serum creatinine >2.0 mg/dL

Risk Classification:

• Class I (0 points): 0.4% risk
• Class II (1 point): 0.9% risk
• Class III (2 points): 6.6% risk
• Class IV (≥3 points): >11% risk

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: Check all risk factors that apply to the patient. The calculator will sum the points and provide the corresponding risk class and percentage.

5. Frequently Asked Questions (FAQ)

Q1: What constitutes high-risk surgery?
A: Typically intraperitoneal, intrathoracic, or suprainguinal vascular procedures. Emergency surgeries also carry higher risk.

Q2: How accurate is this risk index?
A: The index has good discrimination with c-statistics around 0.75-0.80 in validation studies.

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

Q4: Should this be used for all patients?
A: It's most useful for patients undergoing non-cardiac surgery. Not validated for cardiac surgery patients.

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