Cardiac Anesthesia Risk Evaluation (CARE) Score

Q: What is the clinical evidence from this study?

Study design: Review. Population: Cardiac surgery. Intervention: Cardiac Anesthesia Risk Evaluation (CARE) Score vs. STS score, EuroSCORE, EuroSCORE II (historical/literature comparison). Primary outcome: Mortality and major morbidity after cardiac surgery.

Allen Friedman

doi:10.65357/001c.160291

April 17, 2026Evidence to Action Official Journal of MDCalc

Cardiac Anesthesia Risk Evaluation (CARE) Score

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Key result

. No new claims.

Why the study?

Does the CARE score accurately predict mortality and morbidity in adult patients undergoing cardiac surgery?

Key Points

To review the structure, clinical utility, and predictive accuracy of the Cardiac Anesthesia Risk Evaluation (CARE) score for post-cardiac surgery outcomes.
Evaluated the five-tier ordinal CARE scoring framework and emergency modifier ('E') based on comorbidity control, surgical complexity, and procedural urgency in adult cardiac surgery patients over 18 years of age.
Excluded heart transplantation and ventricular assist device insertion procedures from score validation.
Assessed comparative performance against established risk tools (EuroSCORE and STS score) and hemodynamic outcomes from clinical validation cohorts.
Areas under the receiver operating characteristic curves for CARE were approximately 0.615 for postoperative complications and 0.726 for in-hospital mortality.
In CARE 3 and 4 patients, mortality increased by 18% for each additional 10 minutes of mean arterial pressure between 55 and 64 mmHg post-cardiopulmonary bypass, and by 30% for each 10 minutes below 55 mmHg.
The tool demonstrated stable calibration comparable to EuroSCORE and STS, though it tended to overestimate risk in very high-risk patients and predicted length of stay less reliably.

Structured PICO

Does the CARE score accurately predict mortality and morbidity in adult patients undergoing cardiac surgery?

P

Population

Adult patients over eighteen years of age undergoing cardiac surgery (excluding ventricular assist device insertion or heart transplantation)

I

Intervention

Cardiac Anesthesia Risk Evaluation (CARE) Score

O

Outcome

Mortality and major morbidity after cardiac surgerycomposite

Limitations

Tends to overestimate perioperative risk in patients who fall into the very high-risk category
Developed primarily from a single-center national cohort, limiting widespread validation
Performed poorly in forecasting hospital and ICU length of stay
Less effective in predicting outcomes compared to frailty measures
Not validated for ventricular assist device insertion or heart transplantation
Overestimates perioperative risk in very high-risk patients
Developed primarily from a single-center national cohort

Implication

The CARE score is a practical, rapid risk stratification system that provides comparable discrimination and calibration to EuroSCORE and STS for predicting mortality and morbidity after cardiac surgery.

Abstract

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Discussion

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Cite This Study

Allen Friedman (2026) conducted a review in Cardiac surgery. Cardiac Anesthesia Risk Evaluation (CARE) Score vs. STS score, EuroSCORE, EuroSCORE II (historical/literature comparison) was evaluated on Mortality and major morbidity after cardiac surgery. The Cardiac Anesthesia Risk Evaluation (CARE) score provides practical risk stratification for predicting mortality and major morbidity after cardiac surgery with discrimination comparable to EuroSCORE and STS.

synapsesocial.com/papers/69e4739a010ef96374d8f559 https://doi.org/10.65357/001c.160291

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Cardiac Anesthesia Risk Evaluation (CARE) Score

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Cardiac Anesthesia Risk Evaluation (CARE) Score

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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