Revised Cardiac Risk Index (Lee Criteria)

Rapid pre-op assessment using the Revised Cardiac Risk Index

The global unit selector only affects unanswered questions
1.High Risk Surgery?
2.Coronary Artery Disease?
3.Congestive Heart Failure?
4.Cerebrovascular Disease?
5.Diabetes Mellitus on Insulin?
6.Serum Creatinine >2 mg/dl or >177 μmol/L?
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1. High Risk Surgery?

More Information

High Risk Surgery defined as: Intraperitoneal, intrathoracic, or suprainguinal vascular

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About this Calculator

The revised cardiac risk index was developed from stable patients aged 50 years or more undergoing elective major non-cardiac procedures in a tertiary-care teaching hospital. This index can identify patients at higher risk for complications such as myocardial infarction, pulmonary edema, ventricular fibrillation or primary cardiac arrest, and complete heart block. This index may be useful for identification of candidates for further risk stratification with noninvasive technologies or other management strategies (moderate risk or above), as well as low-risk patients in whom additional evaluation is unlikely to be helpful. This risk index should be used in the context of the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery.


Thomas H. Lee, MD, SM; Edward R. Marcantonio, MD, SM; Carol M. Mangione, MD, SM; Eric J. Thomas, MD, SM; Carisi A. Polanczyk, MD; E. Francis Cook, ScD; David J. Sugarbaker, MD; Magruder C. Donaldson, MD; Robert Poss, MD; Kalon K. L. Ho, MD, SM; Lynn E. Ludwig, MS, RN; Alex Pedan, PhD; Lee Goldman, MD, MPH.

Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery.

Circulation 1999 September 7, 100 (10): 1043-9

Lee A. Fleisher, Joshua A. Beckman, Kenneth A. Brown, Hugh Calkins, Elliot L. Chaikof, Kirsten E. Fleischmann, William K. Freeman, James B. Froehlich, Edward K. Kasper, Judy R. Kersten, Barbara Riegel and John F. Robb.

2009 ACCF/AHA focused update on perioperative beta blockade incorporated into the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American college of cardiology foundation/American heart association task force on practice guidelines.

Circulation 2009 November 24, 120 (21): e169-276

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