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Use of a modified Revised Cardiac Risk Index (RCRI) by Lindenauer et al to Select a Patient for Perioperative Beta-Blocker Therapy in Major Noncardiac Surgery

Purpose: To determine if a patient undergoing noncardiac surgery is likely to benefit from perioperative beta-blocker therapy based on the study of Lindenauer et al.

Description

Lindenauer et al used the revised cardiac risk index (RCRI) to identify patients who may or may not benefit from perioperative beta-blocker therapy. The authors are from Baystate Medical Center in Springfield, Massachusetts, and the University of Massachusetts at Amherst.


The revised cardiac risk index (RCRI) was developed by Lee et al and is discussed in 06.03.05.

 

Components of the modified RCRI:

(1) high risk surgery (intrathoracic, intra-peritoneal, suprainguinal vascular)

(2) ischemic heart disease

(3) diabetes mellitus

(4) renal insufficiency

(5) cerebrovascular disease

 

The original RCRI also included congestive heart failure, but this was not used by Lindenauer et al. The original RCRI also specified insulin-dependent diabetes mellitus.

 

The modified RCRI consists of 1 point for each component present.

 

Interpretation:

• minimum modified RCRI: 0

• maximum modified RCRI: 5

• A person with an index >= 2 is likely to benefit from perioperative beta-blocker therapy.

 

Modified RCRI

Outcome with Perioperative Beta-Blocker Therapy

0 or 1

no benefit and may harm

2 to 5

reduced risk of death in hospital

 


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Specialty

Objective

ICD-10