Lee Revised Cardiac Risk Index (RCRI) Calculator

Lee Revised Cardiac Risk Index (RCRI) for perioperative cardiac risk in non-cardiac surgery (0–6).

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.

High-risk surgery (intraperitoneal, intrathoracic, or suprainguinal vascular)

History of ischemic heart disease

History of congestive heart failure

History of cerebrovascular disease (stroke or TIA)

Preoperative insulin therapy for diabetes

Preoperative creatinine > 2.0 mg/dL

Score

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Interpretation

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References

Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100(10):1043-1049.

How to use

Select each of the six RCRI predictors that applies to the patient.
The total index (0–6) and major cardiac event risk update instantly.
Use in preoperative evaluation to guide further cardiac work-up.

Frequently asked questions

What is the Revised Cardiac Risk Index?

The Lee RCRI is a 6-factor index that estimates the risk of major perioperative cardiac complications in patients undergoing non-cardiac surgery.

What outcome does the RCRI predict?

Major cardiac complications: myocardial infarction, pulmonary edema, ventricular fibrillation or cardiac arrest, and complete heart block.

How is the RCRI used in preoperative assessment?

An RCRI ≥ 2 (elevated risk) prompts consideration of functional capacity assessment and, in selected cases, biomarkers or further cardiac evaluation per ACC/AHA and ESC guidelines.

Does a low RCRI guarantee a safe operation?

No — RCRI estimates population risk; individual factors (frailty, anemia, surgery urgency) and intraoperative events also matter.

Last updated June 28, 2026