{
  "resourceType": "StructureDefinition",
  "id": "logicalmodel-Revisedcardiacriskindex-R4",
  "url": "http://linkehr.com/fhir/logicalmodel-revisedcardiacriskindex-R4",
  "identifier": [
    {
      "system": "openEHR-CKM",
      "value": "openEHR-EHR-OBSERVATION.revised_cardiac_risk_index.v1"
    }
  ],
  "version": "0",
  "name": "Revisedcardiacriskindex",
  "title": "Revised cardiac risk index",
  "status": "draft",
  "date": "2024-06-18",
  "publisher": "openEHR",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.veratech.es"
        }
      ]
    }
  ],
  "description": "The Revised Cardiac Risk Index (RCRI) is a preoperative prediction tool to estimate the perioperative risk of major cardiac complications during non-cardiac surgery.",
  "purpose": "To record the result for each component parameter, and their total sum and estimated risk for the Revised Cardiac Risk Index (RCRI).",
  "fhirVersion": "4.0.0",
  "mapping": [
    {
      "identity": "openEHR",
      "uri": "http://openehr.org",
      "name": "openEHR Mapping"
    },
    {
      "identity": "openEHR-natural",
      "uri": "http://openehr.org",
      "name": "openEHR natural path"
    }
  ],
  "kind": "logical",
  "abstract": false,
  "type": "StructureDefinition",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Element",
  "snapshot": {
    "element": [
      {
        "id": "Revised_cardiac_risk_index",
        "path": "Revised_cardiac_risk_index",
        "short": "Revised cardiac risk index",
        "definition": "The Revised Cardiac Risk Index (RCRI) is a preoperative prediction tool to estimate the perioperative risk of major cardiac complications during non-cardiac surgery.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.protocol",
        "path": "Revised_cardiac_risk_index.protocol",
        "short": "Item tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.protocol",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.protocol.Extension",
        "path": "Revised_cardiac_risk_index.protocol.Extension",
        "short": "Extension",
        "definition": "Additional information required to extend the model with local content or to align with other reference models or formalisms.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Revised_cardiac_risk_index.protocol.Extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History",
        "path": "Revised_cardiac_risk_index.History",
        "short": "History",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event",
        "path": "Revised_cardiac_risk_index.History.Any_event",
        "short": "Any event",
        "definition": "Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event",
          "min": 0,
          "max": "*"
        },
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            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data",
        "path": "Revised_cardiac_risk_index.History.Any_event.data",
        "short": "Tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data",
          "min": 0,
          "max": "1"
        },
        "type": [
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            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Ischemic_heart_disease",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Ischemic_heart_disease",
        "short": "Ischemic heart disease",
        "definition": "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Ischemic_heart_disease",
          "min": 0,
          "max": "1"
        }
      },
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        "id": "Revised_cardiac_risk_index.History.Any_event.data.Ischemic_heart_disease.value",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Ischemic_heart_disease.value",
        "short": "Ischemic heart disease",
        "definition": "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Ischemic_heart_disease.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Congestive_heart_failure",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Congestive_heart_failure",
        "short": "Congestive heart failure",
        "definition": "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Congestive_heart_failure",
          "min": 0,
          "max": "1"
        }
      },
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        "id": "Revised_cardiac_risk_index.History.Any_event.data.Congestive_heart_failure.value",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Congestive_heart_failure.value",
        "short": "Congestive heart failure",
        "definition": "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Congestive_heart_failure.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Cerebrovascular_disease",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Cerebrovascular_disease",
        "short": "Cerebrovascular disease",
        "definition": "History of stroke, cerebrovascular accident (CVA) with minor or no residual or transient ischemic attacks (TIA).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Cerebrovascular_disease",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Cerebrovascular_disease.value",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Cerebrovascular_disease.value",
        "short": "Cerebrovascular disease",
        "definition": "History of stroke, cerebrovascular accident (CVA) with minor or no residual or transient ischemic attacks (TIA).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Cerebrovascular_disease.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Diabetes_mellitus_on_insulin",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Diabetes_mellitus_on_insulin",
        "short": "Diabetes mellitus on insulin",
        "definition": "Diabetes mellitus treated with insulin.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Diabetes_mellitus_on_insulin",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Diabetes_mellitus_on_insulin.value",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Diabetes_mellitus_on_insulin.value",
        "short": "Diabetes mellitus on insulin",
        "definition": "Diabetes mellitus treated with insulin.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Diabetes_mellitus_on_insulin.value",
          "min": 0,
          "max": "1"
        },
        "type": [
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            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Elevated_serum_creatinine",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Elevated_serum_creatinine",
        "short": "Elevated serum creatinine",
        "definition": "Preoperative serum Creatinine ≥2 mg/dl or ≥177 μmol/L.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Elevated_serum_creatinine",
          "min": 0,
          "max": "1"
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        "id": "Revised_cardiac_risk_index.History.Any_event.data.Elevated_serum_creatinine.value",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Elevated_serum_creatinine.value",
        "short": "Elevated serum creatinine",
        "definition": "Preoperative serum Creatinine ≥2 mg/dl or ≥177 μmol/L.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Elevated_serum_creatinine.value",
          "min": 0,
          "max": "1"
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            "code": "CodeableConcept"
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        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.High_risk_surgery",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.High_risk_surgery",
        "short": "High risk surgery",
        "definition": "Surgical procedures that carry a significant risk of complications or adverse events e.g. intraperitoneal, intrathoracic, or suprainguinal vascular procedures.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.High_risk_surgery",
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        "id": "Revised_cardiac_risk_index.History.Any_event.data.High_risk_surgery.value",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.High_risk_surgery.value",
        "short": "High risk surgery",
        "definition": "Surgical procedures that carry a significant risk of complications or adverse events e.g. intraperitoneal, intrathoracic, or suprainguinal vascular procedures.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.High_risk_surgery.value",
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      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Total_score",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Total_score",
        "short": "Total score",
        "definition": "The total sum of each component variable for the Revised cardiac risk index.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Total_score",
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        "id": "Revised_cardiac_risk_index.History.Any_event.data.Total_score.value",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Total_score.value",
        "short": "Total score",
        "definition": "The total sum of each component variable for the Revised cardiac risk index.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Revised_cardiac_risk_index.History.Any_event.data.Total_score.value",
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            "code": "Quantity"
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        ],
        "mustSupport": false,
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        "isSummary": true
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      {
        "id": "Revised_cardiac_risk_index.History.Any_event.data.Estimated_risk",
        "path": "Revised_cardiac_risk_index.History.Any_event.data.Estimated_risk",
        "short": "Estimated risk",
        "definition": "Estimated risk of major cardiac complications (myocardial infarction, pulmonary edema, ventricular fibrillation or primary cardiac arrest, and complete heart block) after non-cardiac surgery: \r\n0 points = Very low risk; \r\n1 point = Low risk; \r\n2 points = Moderate risk; \r\n≥3 points = High risk.",
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        "path": "Revised_cardiac_risk_index.History.Any_event.data.Estimated_risk.value",
        "short": "Estimated risk",
        "definition": "Estimated risk of major cardiac complications (myocardial infarction, pulmonary edema, ventricular fibrillation or primary cardiac arrest, and complete heart block) after non-cardiac surgery: \r\n0 points = Very low risk; \r\n1 point = Low risk; \r\n2 points = Moderate risk; \r\n≥3 points = High risk.",
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}