Anaes SAQs · Vascular anaesthesia
Perioperative cardiac risk: Revised Cardiac Risk Index (RCRI)
Final-examination SAQ for perioperative-cardiac-risk-rcri.
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ANZCAFRCAEDAICABAFCAI
Prompt
List the RCRI predictors exactly and discuss perioperative beta-blockade in light of POISE for a vascular patient.
Model answer
Six predictors (6). High-risk surgery; IHD; HF; CVA/TIA; insulin DM; Cr >2 mg/dL (177 µmol/L).[1]
Use (4). Risk bands; limitations, as the cited Lee-RCRI teaching above states.[1]
POISE (5). Acute high-dose metoprolol ↓MI but ↑stroke/death — do not naive-load.[2]
References3ShowHide
- [1]Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation, 1999.PMID 10477528
- [2]Devereaux PJ, Yang H, Yusuf S, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial). Lancet, 2008.PMID 18479744
- [3]Lewis SC, Warlow CP, Bodenham AR, et al. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. Lancet, 2008.PMID 19041130