Key result
CARE scores show limited discrimination for early postoperative complications affecting ~44% of cardiac surgery patients.
Why the study?
Early postoperative complications are major determinants of outcomes after cardiac surgery, but perioperative data remain limited in low- and middle-income countries.
Cohort (n=108)
No
Early postoperative complications are highly prevalent (43.5%) in LMIC cardiac surgery patients, and existing risk scores like CARE show only limited to moderate discrimination for predicting morbidity.
Answers are grounded in this paper and cite their sources.
Signals substantial early cardiovascular vulnerability postoperatively; leaves open effective mitigation in future randomized trials.
BACKGROUND: Early postoperative complications are major determinants of outcomes after cardiac surgery, particularly in low- and middle-income countries (LMICs), where perioperative data remain limited. AIM: To describe the incidence and spectrum of early postoperative complications within the first 24 hours after cardiac surgery and to characterize preoperative risk profiles using cardiac anesthesia risk evaluation (CARE) and European system for cardiac operative risk evaluation (EuroSCORE) II. SETTINGS AND DESIGN: Retrospective, single-center cohort study conducted at a national referral hospital. MATERIALS AND METHODS: A total of 108 adult patients undergoing cardiac surgery with cardiopulmonary bypass between 2017 and 2021 were included. Baseline clinical and surgical variables were collected. Early postoperative complications were recorded by organ system. CARE and EuroSCORE II were calculated preoperatively due to absence of mortality data. STATISTICAL ANALYSIS USED: Descriptive analysis was performed. The discriminative ability of CARE-predicted morbidity was evaluated using the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals. RESULTS: The mean age was 50.1 ± 17.1 years, and 52.8% were women. Early postoperative complications occurred in 47 patients (43.5%), most frequently cardiovascular (42 patients, 38.9%), followed by renal complications requiring renal replacement therapy (11, 10.2%), infectious (9, 8.3%), and respiratory complications (8, 7.4%). CARE-predicted morbidity showed limited to moderate discrimination (AUC 0.67; 95% CI 0.58-0.77). EuroSCORE II was reported descriptively. CONCLUSION: Early postoperative morbidity is common in this LMIC cohort, with cardiovascular complications predominating. CARE-predicted morbidity showed limited to moderate discrimination, supporting cautious interpretation and highlighting the need for improved perioperative outcome monitoring.
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Velásquez et al. (2026) conducted a cohort in Cardiac surgery (n=108). Cardiac surgery with cardiopulmonary bypass was evaluated on Early postoperative complications within the first 24 hours (AUC 0.67, 95% CI 0.58-0.77). Cardiac surgery resulted in early postoperative complications in 43.5% of patients, while CARE-predicted morbidity showed limited discrimination (AUC 0.67; 95% CI 0.58-0.77).
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