Revised Cardiac Risk Index (RCRI)
Estimates perioperative cardiac risk for non-cardiac surgery
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- Emergency department, Inpatient
Calculate
Answer every item. The result uses the same scoring code Scribeable runs in notes. Nothing you enter leaves this page.
High-risk surgery (intraperitoneal, intrathoracic or suprainguinal vascular)
History of ischemic heart disease
History of congestive heart failure
History of cerebrovascular disease
Preoperative treatment with insulin
0.1 to 30 mg/dL.
Enter the values above to see the result.
When it activates
Scribeable activates a calculator from the encounter. The Revised Cardiac Risk Index (RCRI) can activate when the transcript or pasted chart context documents any of these:
- Pre-operative evaluation
- Surgical clearance
- Non-cardiac surgery risk assessment
- Perioperative management planning
Note-type scope: it activates on notes whose subject resolves to perioperative, cardiology, hospital medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
7 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| High-risk surgery (intrathoracic, intraabdominal, suprainguinal vascular) | history | ||
| History of ischemic heart disease | history | ||
| History of CHF | history | ||
| History of cerebrovascular disease | history | ||
| Pre-operative insulin treatment | medication | ||
| Pre-op creatinine >2 mg/dLoptional | lab | ||
| Pre-op serum creatinine (mg/dL)optional | lab | mg/dL | Pre-op serum creatinine; RCRI scores a point when >2.0 mg/dL. |
Scoring
1 point each: High-risk surgery, IHD, CHF, CVD, insulin use, Cr >2
High-risk surgery High-risk surgery (intrathoracic, intraabdominal, suprainguinal vascular) + IHD History of ischemic heart disease + CHF History of CHF + CVD History of cerebrovascular disease + insulin Pre-operative insulin treatment + Cr Pre-op serum creatinine (mg/dL) (flag if >2)
Interpretation
Major cardiac complications by number of factors (Lee 1999, validation cohort): 0: 0.4%. 1: 0.9%. 2: 7%. >=3: 11%.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Lee TH et al. Derivation and prospective validation of a simple index for prediction of cardiac risk (RCRI)Lee et al. (RCRI) 1999 · 1999 · Level I · link last verified 2026-03-23
How Scribeable handles it in the note
When an encounter activates the Revised Cardiac Risk Index (RCRI) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a Revised Cardiac Risk Index (RCRI) value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.
See it activate on your own encounter
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