RCRI (Revised Cardiac Risk Index)

Lee Index — predicts 30-day major adverse cardiac events (MACE) for non-cardiac surgery.

High-risk surgery

Intrathoracic, intraperitoneal, or suprainguinal vascular

Ischemic heart disease

MI, +stress test, current angina, NTG use, or pathologic Q waves

Heart failure

CHF history, pulmonary edema, paroxysmal nocturnal dyspnea, bilateral rales, or S3

Cerebrovascular disease

Prior stroke or TIA

Insulin-dependent diabetes

Diabetes requiring insulin (any type)

Creatinine > 2 mg/dL (177 µmol/L)

Score

0 / 6

Low risk

Show working

· High-risk surgery (intrathoracic, intraperitoneal, suprainguinal vascular)
· Ischemic heart disease
· Heart failure
· Cerebrovascular disease (TIA/stroke)
· Insulin-dependent diabetes
· Creatinine > 2 mg/dL
Score: 0
Estimated 30-day MACE risk: 0.4%

Clinical note:RCRI ≥ 2 → consider cardiac evaluation per ACC/AHA. METs < 4 + intermediate/high RCRI → stress test or further workup may be warranted. Education only.