ARCHETYPE Revised cardiac risk index (openEHR-EHR-OBSERVATION.revised_cardiac_risk_index.v1)

ARCHETYPE ID	openEHR-EHR-OBSERVATION.revised_cardiac_risk_index.v1
Concept	Revised cardiac risk index
Description	The Revised Cardiac Risk Index (RCRI) is a preoperative prediction tool to estimate the perioperative risk of major cardiac complications during non-cardiac surgery.
Use	Use to record the Revised cardiac risk index (RCRI).
Purpose	To record the result for each component parameter, and their total sum and estimated risk for the Revised Cardiac Risk Index (RCRI).
References	Lee T, Marcantonio E, Mangione C, Thomas E, Polanczyk C, Cook F, Sugarbaker D, Donaldson M, Poss R, Ho K, Ludwig L , Pedan A, Goldman L. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation, 1999 Sep 7;100(10):1043-9. Fleisher L, Beckman J, Brown K, Calkins H, Chaikof E, Fleischmann K, Freeman W, Froehlich J, Kasper E, Kersten J, Riegel B, Robb J. 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 Nov 24;120(21):e169-276.
Authors	Author name: Olha Nikolaieva Organisation: University Hospital Basel Email: olha.nikolaieva@usb.ch Date originally authored: 2024-02-28
Other Details Language	Author name: Olha Nikolaieva Organisation: University Hospital Basel Email: olha.nikolaieva@usb.ch Date originally authored: 2024-02-28
Other Details (Language Independent)	Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/. Custodian Organisation: openEHR Foundation References: Lee T, Marcantonio E, Mangione C, Thomas E, Polanczyk C, Cook F, Sugarbaker D, Donaldson M, Poss R, Ho K, Ludwig L , Pedan A, Goldman L. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation, 1999 Sep 7;100(10):1043-9. Fleisher L, Beckman J, Brown K, Calkins H, Chaikof E, Fleischmann K, Freeman W, Froehlich J, Kasper E, Kersten J, Riegel B, Robb J. 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 Nov 24;120(21):e169-276. Original Namespace: org.openehr Original Publisher: openEHR Foundation Custodian Namespace: org.openehr MD5-CAM-1.0.1: 28D3E43E85E6FD48929C167FF821F6E6 Build Uid: 79019d0a-61ec-4108-b7f6-c1378317498a Ip Acknowledgements: This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/snomed-ct/get-snomed or info@snomed.org. Revision: 1.0.0
Keywords	Revised cardiac risk index, RCRI, Lee score, Lee index, perioperative risk, myocardial infarction, MI, cardiac arrest, risk, anesthesia, preoperative assessment.
Lifecycle	published
UID	b8552dfb-88cf-4020-adbe-e812632e0ecb
Language used	en
Citeable Identifier	1246.145.2593
Revision Number	1.0.0
protocol
Extension	Extension: Additional information required to extend the model with local content or to align with other reference models or formalisms. For example: local information requirements; or additional metadata to align with FHIR. Include: All not explicitly excluded archetypes
data
Ischemic heart disease	Ischemic heart disease: History of probable or definite myocardial infarction (MI; ECG changes and/or enzyme changes); history of positive exercise test; current chest pain considered due to myocardial ischemia; use of nitrate therapy; ECG with pathological Q waves. 0: at0008::Absent [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::2667000 | Absent] 1: at0009::Present [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::52101004 | Present (qualifier value)]
Congestive heart failure	Congestive heart failure: History of congestive heart failure; pulmonary edema; paroxysmal nocturnal dyspnea; physical examination showing bilateral rales or S3 gallop; chest radiograph showing pulmonary vascular redistribution; has responded symptomatically (or on physical examination) to digitalis, diuretics, or afterload reducing agents. 0: at0011::Absent [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::2667000 | Absent] 1: at0012::Present [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::52101004 | Present (qualifier value)]
Cerebrovascular disease	Cerebrovascular disease: History of stroke, cerebrovascular accident (CVA) with minor or no residual or transient ischemic attacks (TIA). 0: at0014::Absent [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::2667000 | Absent] 1: at0015::Present [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::52101004 | Present (qualifier value)]
Diabetes mellitus on insulin	Diabetes mellitus on insulin: Diabetes mellitus treated with insulin. 0: at0017::Absent [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::2667000 | Absent] 1: at0018::Present [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::52101004 | Present (qualifier value)]
Elevated serum creatinine	Elevated serum creatinine: Preoperative serum Creatinine ≥2 mg/dl or ≥177 μmol/L. 0: at0005::Preoperative serum creatinine <2 mg/dl or <177 μmol/L. 1: at0006::Preoperative serum creatinine ≥2 mg/dl or ≥177 μmol/L.
High risk surgery	High risk surgery: Surgical procedures that carry a significant risk of complications or adverse events e.g. intraperitoneal, intrathoracic, or suprainguinal vascular procedures. 0: at0023::Absent [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::2667000 | Absent] 1: at0024::Present [ Draft This term binding has NOT yet been formally reviewed or confirmed. SNOMED-CT::52101004 | Present (qualifier value)]
Total score	Total score: The total sum of each component variable for the Revised cardiac risk index. min: >=0; max: <=6
Estimated risk	Estimated risk: Estimated risk of major cardiac complications (myocardial infarction, pulmonary edema, ventricular fibrillation or primary cardiac arrest, and complete heart block) after non-cardiac surgery: 0 points = Very low risk; 1 point = Low risk; 2 points = Moderate risk; ≥3 points = High risk. at0028::Very low risk [According to Lee et al. equivalent to 0.4%.] at0029::Low risk [According to Lee et al. equivalent to 0.9%.] at0030::Moderate risk [According to Lee et al. equivalent to 6.6%.] at0031::High risk [According to Lee et al. ≥11%.]
events
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Other contributors	Amanda Herbrand, University Hospital Basel, Switzerland Jannis Pesch, University Hospital Basel, Switzerland Jan Steiner, University Hospital Basel, Switzerland Markus Obreiter, University Hospital Basel, Switzerland
Translators	German: Olha Nikolaieva, Amanda Herbrand, University Hospital Basel, Switzerland, olha.nikolaieva@usb.ch, amanda.herbrand@usb.ch