The Lee Criteria for Perioperative Cardiovascular Risk Assessment.
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if (document.getElementById('ischemicHeart').checked) score++;
if (document.getElementById('congestiveHeart').checked) score++;
if (document.getElementById('cerebrovascular').checked) score++;
if (document.getElementById('insulinDiabetes').checked) score++;
if (document.getElementById('renalInsufficiency').checked) score++;
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if (score === 0) {
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riskClass = "Class I (Very Low Risk)";
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riskPercent = "0.9%";
riskClass = "Class II (Low Risk)";
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riskPercent = "6.6%";
riskClass = "Class III (Moderate Risk)";
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riskClass = "Class IV (High Risk)";
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scoreDisplay.innerHTML = "Total RCRI Score: " + score;
classDisplay.innerHTML = riskClass;
riskDisplay.innerHTML = "Estimated Risk of Major Cardiac Complications: " + riskPercent;
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Understanding the Revised Cardiac Risk Index (RCRI)
The Revised Cardiac Risk Index (RCRI), also known as the Lee Criteria, is a clinical tool used by anesthesiologists and surgeons to estimate the risk of major cardiac complications (such as myocardial infarction, cardiac arrest, or complete heart block) following non-cardiac surgery.
The Six Clinical Predictors
The RCRI is based on six distinct independent predictors identified in clinical studies. Each factor is worth one point:
High-risk Surgery: Includes vascular, thoracic, or abdominal procedures where fluid shifts and physiological stress are higher.
Ischemic Heart Disease: A history of heart attack, current angina, or a previous positive stress test.
Congestive Heart Failure: Past or present symptoms such as pulmonary edema or paroxysmal nocturnal dyspnea.
Cerebrovascular Disease: Patients who have previously experienced a stroke or a Transient Ischemic Attack (TIA).
Diabetes Mellitus: Specifically patients who require insulin to manage their blood sugar levels.
Once the points are summed, the patient is assigned to a risk class that correlates with the likelihood of a major adverse cardiac event (MACE) within 30 days of the procedure.
Score
Class
Complication Risk
0 Points
Class I
0.4%
1 Point
Class II
0.9%
2 Points
Class III
6.6%
3+ Points
Class IV
11.0%
Why the RCRI Matters
Preoperative assessment is crucial for patient safety. By identifying high-risk patients, medical teams can decide if further cardiac testing (like an echocardiogram or stress test) is necessary, optimize medications like beta-blockers or statins, and determine the appropriate level of post-operative monitoring (e.g., ICU vs. standard ward).
Medical Disclaimer: This calculator is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.