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Editorials |

The Revised Cardiac Risk Index Delivers What It Promised

Lee Goldman, MD, MPH
[+] Article, Author, and Disclosure Information

From Columbia University, New York, NY 10032.

Potential Conflicts of Interest: None disclosed.

Requests for Single Reprints: Lee Goldman, MD, MPH, Columbia University, 630 West 168th Street, P&S 2-401, New York, NY 10032; e-mail, lgoldman@columbia.edu.

Ann Intern Med. 2010;152(1):57-58. doi:10.7326/0003-4819-152-1-201001050-00013
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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), for this important purpose. Its performance in the subgroup of patients undergoing vascular surgery was good but not as accurate as its overall performance. It is also useful for predicting overall operative mortality, an outcome for which it was not designed.


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