All calculators
Cardiovascular
Revised Cardiac Risk Index (RCRI)
Estimate perioperative major adverse cardiac event (MACE) risk before non-cardiac surgery.
When to use: Apply RCRI in the preoperative assessment of adults undergoing elective non-cardiac surgery to estimate major adverse cardiac event risk. RCRI ≥3 warrants cardiology referral and optimisation before proceeding. It also informs the decision to obtain preoperative cardiac testing (stress test, echocardiogram) and whether beta-blocker continuation or initiation is appropriate.
Calculator
Fill in all fields to see the result
Formula
RCRI = High-risk surgery(1) + IHD(1) + CHF(1) + CVD(1) + Insulin-dependent DM(1) + Preop Cr >2 mg/dL(1)
Score 0: 3.9% MACE | 1: 6.0% | 2: 10.1% | ≥3: ≥15%
Key Points for NEET PG
- RCRI (Lee Index, 1999): 6 independent predictors of perioperative cardiac complications.
- MACE = Major Adverse Cardiac Events: cardiac death, non-fatal MI, non-fatal cardiac arrest.
- Score 0 = 3.9%, 1 = 6%, 2 = 10.1%, ≥3 = ≥15% MACE risk — these numbers are directly tested in anaesthesia/surgery MCQs.
- Beta-blockers: continue if patient is already on them; do NOT initiate on the day of surgery (worsens outcomes) — start 1–2 weeks before if indicated.
- ACC/AHA guidelines: functional capacity ≥4 METs (can climb one flight of stairs or walk on level ground at 4 mph) is reassuring — proceed without further cardiac testing.
References
Lee TH et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery · Circulation (1999)
Fleisher LA et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery · J Am Coll Cardiol (2014)
For educational purposes only. Not for clinical decision-making without professional oversight.