New Perioperative Risk Index for Vascular Surgery Patients

The Revised Cardiac Risk Index (RCRI) — widely used to determine cardiac risk in patients undergoing noncardiac surgery — was derived from analysis of 4300 patients at one Boston teaching hospital; vascular surgical procedures comprised only 900 of those surgeries (JW Gen Med Sep 17 1999). Now, researchers from a consortium of 20 New England hospitals have derived a new risk index from a database of 10,000 patients who underwent carotid endarterectomy (53%), lower-extremity bypass (27%), or open (11%) or endovascular (10%) repair of abdominal aortic aneurysms (AAAs).

Six percent of patients suffered perioperative cardiac complications (myocardial infarction, clinically significant arrhythmia, or congestive heart failure). Using multivariate …