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

ARCHETYPE IDopenEHR-EHR-OBSERVATION.revised_cardiac_risk_index.v1
ConceptRevised cardiac risk index
DescriptionThe Revised Cardiac Risk Index (RCRI) is a preoperative prediction tool to estimate the perioperative risk of major cardiac complications during non-cardiac surgery.
UseUse to record the Revised cardiac risk index (RCRI).
PurposeTo record the result for each component parameter, and their total sum and estimated risk for the Revised Cardiac Risk Index (RCRI).
ReferencesLee 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.
AuthorsAuthor name: Olha Nikolaieva
Organisation: University Hospital Basel
Email: olha.nikolaieva@usb.ch
Date originally authored: 2024-02-28
Other Details LanguageAuthor name: Olha Nikolaieva
Organisation: University Hospital Basel
Email: olha.nikolaieva@usb.ch
Date originally authored: 2024-02-28
OtherDetails 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}
KeywordsRevised cardiac risk index, RCRI, Lee score, Lee index, perioperative risk, myocardial infarction, MI, cardiac arrest, risk, anesthesia, preoperative assessment.
Lifecyclepublished
UIDb8552dfb-88cf-4020-adbe-e812632e0ecb
Language useden
Citeable Identifier1013.1.7178
Revision Number1.0.0
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=[SNOMED-CT::448236008 | Revised cardiac risk index], archetypeConceptDescription=The Revised Cardiac Risk Index (RCRI) is a preoperative prediction tool to estimate the perioperative risk of major cardiac complications during non-cardiac surgery., archetypeConceptComment=null, otherContributors=Amanda Herbrand, University Hospital Basel, Switzerland
Jannis Pesch, University Hospital Basel, Switzerland
Jan Steiner, University Hospital Basel, Switzerland
Markus Obreiter, University Hospital Basel, Switzerland, originalLanguage=en, translators=
  • German: Olha Nikolaieva, Amanda Herbrand, University Hospital Basel, Switzerland, olha.nikolaieva@usb.ch, amanda.herbrand@usb.ch

  • , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={source=[], identities=[], contacts=[], ism_transition=[], provider=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0025]/items[at0032], code=at0032, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    All not explicitly excluded archetypes, extendedValues=null]], description=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=EVENT, level=2, text=Any event, description=Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVENT, bindings=null, values=null, extendedValues=null]], details=[], context=[], target=[], capabilities=[], items=[], other_participations=[], content=[], state=[], activities=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0007], code=at0007, itemType=ELEMENT, level=4, text=Ischemic heart disease, description=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., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Absent
    [SNOMED-CT::2667000 | Absent]

    1: Present
    [SNOMED-CT::52101004 | Present]

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Congestive heart failure, description=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., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Absent
    [SNOMED-CT::2667000 | Absent]

    1: Present
    [SNOMED-CT::52101004 | Present]

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0013], code=at0013, itemType=ELEMENT, level=4, text=Cerebrovascular disease, description=History of stroke, cerebrovascular accident (CVA) with minor or no residual or transient ischemic attacks (TIA)., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Absent
    [SNOMED-CT::2667000 | Absent]

    1: Present
    [SNOMED-CT::52101004 | Present]

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0016], code=at0016, itemType=ELEMENT, level=4, text=Diabetes mellitus on insulin, description=Diabetes mellitus treated with insulin., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Absent
    [SNOMED-CT::2667000 | Absent]

    1: Present
    [SNOMED-CT::52101004 | Present]

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Elevated serum creatinine, description=Preoperative serum Creatinine ≥2 mg/dl or ≥177 μmol/L., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Preoperative serum creatinine <2 mg/dl or <177 μmol/L.
    1: Preoperative serum creatinine ≥2 mg/dl or ≥177 μmol/L.
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0022], code=at0022, itemType=ELEMENT, level=4, text=High risk surgery, description=Surgical procedures that carry a significant risk of complications or adverse events e.g. intraperitoneal, intrathoracic, or suprainguinal vascular procedures., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Absent
    [SNOMED-CT::2667000 | Absent]

    1: Present
    [SNOMED-CT::52101004 | Present]

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0026], code=at0026, itemType=ELEMENT, level=4, text=Total score, description=The total sum of each component variable for the Revised cardiac risk index., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0; max: <=6

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0027], code=at0027, itemType=ELEMENT, level=4, text=Estimated risk, description=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., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Very low risk [According to Lee et al. equivalent to 0.4%.]
    • Low risk [According to Lee et al. equivalent to 0.9%.]
    • Moderate risk [According to Lee et al. equivalent to 6.6%.]
    • High risk [According to Lee et al. ≥11%.]
    , extendedValues=null]], relationships=[], credentials=[]}, topLevelItems={protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0025], code=at0025, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002]/data[at0003], code=at0003, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0025]/items[at0032], code=at0032, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    All not explicitly excluded archetypes, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]