Does the revised cardiac risk index predict cardiac complications following elective lung resection?

Wotton, Robin, Marshall, Andrea, Kerr, Amy, Bishay, Ehab, Kalkat, Maninder S, Rajesh, Pala B, Steyn, Richard and Naidu, Babu V (2013) Does the revised cardiac risk index predict cardiac complications following elective lung resection? Journal of cardiothoracic surgery, 8. p. 220. ISSN 1749-8090.

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Revised Cardiac Risk Index (RCRI) score and Thoracic Revised Cardiac Risk Index (ThRCRI) score were developed to predict the risks of postoperative major cardiac complications in generic surgical population and thoracic surgery respectively. This study aims to determine the accuracy of these scores in predicting the risk of developing cardiac complications including atrial arrhythmias after lung resection surgery in adults.


We studied 703 patients undergoing lung resection surgery in a tertiary thoracic surgery centre. Observed outcome measures of postoperative cardiac morbidity and mortality were compared against those predicted by risk.


Postoperative major cardiac complications and supraventricular arrhythmias occurred in 4.8% of patients. Both index scores had poor discriminative ability for predicting postoperative cardiac complications with an area under receiver operating characteristic (ROC) curve of 0.59 (95% CI 0.51-0.67) for the RCRI score and 0.57 (95% CI 0.49-0.66) for the ThRCRI score.


In our cohort, RCRI and ThRCRI scores failed to accurately predict the risk of cardiac complications in patients undergoing elective resection of lung cancer. The British Thoracic Society (BTS) recommendation to seek a cardiology referral for all asymptomatic pre-operative lung resection patients with > 3 RCRI risk factors is thus unlikely to be of clinical benefit.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Planned IP Care > Thoracic Surgery
Related URLs:
Depositing User: Mrs Suganthi Vijayaganesh
Date Deposited: 08 Dec 2014 13:56
Last Modified: 08 Dec 2014 13:56

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