title: Clinical utility of the Revised Cardiac Risk Index in non-cardiac surgery for elderly patients: a prospective cohort study.
abstract: OBJECTIVE
  We investigated the association between the Revised Cardiac Risk Index (RCRI) and postoperative outcomes in patients undergoing non-cardiac surgery.
  
  
  METHODS
  The predictive value of the RCRI for the risk of perioperative complications, length of hospital stay and hospital cost were evaluated from a prospective cohort of 119 patients aged ≥65 years undergoing elective major digestive, breast or vascular surgery.
  
  
  RESULTS
  Comparing three groups RCRI 0, 1 and ≥2, the morbidity rates were 0, 30 and 68 %; the median length of hospitalization was 5, 14 and 28 days; and the median cost was 665,000, 1,480,000 and 2,160,000 yen, respectively. The mortality rate was 0 % in all groups. The RCRI 0 group included only non-high-risk (breast and peripheral vascular) surgeries. In addition, comparing the two groups by excluding non-high-risk surgeries (RCRI 1 and ≥2), the median morbidity rates were 31 and 67 %, the median length of hospitalization was 15 and 28 days, and the median cost was 1,550,000 and 2,130,000 yen, respectively. The RCRI score was the only independent predictor of the perioperative complications.
  
  
  CONCLUSIONS
  In the case of non-cardiac surgery, the RCRI can identify patients at higher risk of perioperative complications, a prolonged hospital stay and higher hospital cost.
authors.affiliation: Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hirano
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Suda
authors.forename: Takashi
authors.initials: T
authors.lastname: Oyama
authors.forename: Rieko
authors.initials: R
authors.lastname: Nakamura
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawakubo
authors.forename: Norihito
authors.initials: N
authors.lastname: Wada
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Saikawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Obara
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Jinno
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanabe
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D013505:Digestive System Surgical Procedures / Q000191:economics; D017558:Elective Surgical Procedures / Q000191:economics; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008408:Mastectomy; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment / Q000379:methods*; D014656:Vascular Surgical Procedures / Q000191:economics