The Revised Cardiac Risk Index Delivers What It Promised
Authors: Lee Goldman
Journal: Annals of Internal Medicine (2010)

Editorials5 January 2010The Revised Cardiac Risk Index Delivers What It PromisedLee Goldman, MD, MPHLee Goldman, MD, MPHFrom Columbia University, New York, NY 10032.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-1-201001050-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail When tested in a variety of settings in different types of patients and using inconsistent methods for gathering data and defining outcomes, the Revised Cardiac Risk Index (RCRI) (1) performed essentially identically for predicting major perioperative cardiac complications in 9 studies of more than 5000 patients undergoing mixed major noncardiac surgery over the past decade as it did among the patients on whom it was derived. These data, as presented by Ford and colleagues in this issue (2), show that the RCRI delivered what it promised and confirm it as the best available predictive index, with an admirable accuracy (3), ...References1. Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100:1043-9. [PMID: 10477528] CrossrefMedlineGoogle Scholar2. Ford MK, Beattie WS, Wijeysundera DN. Systematic review: prediction of perioperative cardiac complications and mortality by the Revised Cardiac Risk Index. Ann Intern Med. 2010;152:26-35. LinkGoogle Scholar3. Cook NR. Use and misuse of the receiver operating characteristic curve in risk prediction. Circulation. 2007;115:928-35. [PMID: 17309939] CrossrefMedlineGoogle Scholar4. Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, et al. 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[PMID: 14599629] CrossrefMedlineGoogle Scholar16. Neary WD, Prytherch D, Foy C, Heather BP, Earnshaw JJ. Comparison of different methods of risk stratification in urgent and emergency surgery. Br J Surg. 2007;94:1300-5. [PMID: 17541986] CrossrefMedlineGoogle Scholar17. Fleischmann KE, Beckman JA, Buller CE, Calkins H, Fleisher LA, Freeman WK, et al. 2009 ACCF/AHA focused update on perioperative beta blockade: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009;120:2123-51. [PMID: 19884474] CrossrefMedlineGoogle Scholar18. Leibowitz AB, Porter SB. Perioperative beta-blockade in patients undergoing noncardiac surgery: a review of the major randomized clinical trials. J Cardiothorac Vasc Anesth. 2009;23:684-93. [PMID: 19303328] CrossrefMedlineGoogle Scholar19. Monaco M, Stassano P, Di Tommaso L, Pepino P, Giordano A, Pinna GB, et al. Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study. J Am Coll Cardiol. 2009;54:989-96. [PMID: 19729114] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Columbia University, New York, NY 10032.Disclosures: None disclosed.Corresponding Author: Lee Goldman, MD, MPH, Columbia University, 630 West 168th Street, P&S 2-401, New York, NY 10032; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Prediction of Perioperative Cardiac Complications and Mortality by the Revised Cardiac Risk Index Meredith K. Ford , W. Scott Beattie , and Duminda N. Wijeysundera Metrics Cited ByPreoperative multidisciplinary team decisions for high-risk patients scheduled for noncardiac surgery—a retrospective observational studyA Simple, Reliable, and Validated Preoperative Cardiac Risk IndexPerioperative Risk ModelsEstimation of Cardiac Risk Before Noncardiac Surgery: The Evolution of Cardiac Risk IndicesValidation of a Risk Stratification Index and Risk Quantification Index for Predicting Patient OutcomesThe Surgical Mortality Probability ModelWhat We Talk about When We Talk about Risk: Refining Surgery's Hazards in Medical ThoughtRischio in anestesiaUtility of clinical risk predictors for preoperative cardiovascular risk predictionIndex de risque cardiaque et chirurgie vasculaire : Pas les mêmes pour tousCardiac Risk Index and Vascular Surgery: Not the Same for EveryoneLa gestione perioperatoria del paziente con insufficienza cardiaca cronica 5 January 2010Volume 152, Issue 1Page: 57-58KeywordsCardiac surgeryCreatineMedical risk factorsMyocardial infarctionProspective studiesStenosisSurgeryTroponinVascular surgery ePublished: 5 January 2010 Issue Published: 5 January 2010 CopyrightCopyright © 2010 by American College of Physicians. 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