Question

What is Lee's Cardiac risk index and its clinical application?

Hint:

Lee's Cardiac Risk Index is an important tool for identifying high-risk surgical patients, helping to guide appropriate preoperative care and reduce the likelihood of adverse cardiovascular events.

Answer 1

Step 1: Definition of Lee's Cardiac Risk Index.
Lee's Cardiac Risk Index is a clinical tool used to predict the risk of cardiovascular complications in patients undergoing non-cardiac surgery. It is based on six clinical factors, each assigned a specific score:
1. High-risk type of surgery (e.g., intraperitoneal or intrathoracic surgery) – 2 points.
2. History of ischemic heart disease – 1 point.
3. History of congestive heart failure – 1 point.
4. History of cerebrovascular disease – 1 point.
5. Preoperative serum creatinine >2 mg/dL – 1 point.
6. Insulin-dependent diabetes – 1 point.
The total score provides an estimate of the patient's risk for perioperative cardiac complications. A score of 0 indicates low risk, while higher scores indicate an increased risk of complications.

Step 2: Clinical application.
Lee's Cardiac Risk Index is used in clinical practice to stratify patients based on their risk of cardiac events during or after surgery. This helps guide decisions regarding perioperative management, including the need for additional cardiac evaluations, medication adjustments, or more intensive monitoring during surgery. Patients with a higher score may require further preoperative testing or more careful perioperative monitoring.