Key result
Integrating intrinsic surgical risk with patient comorbidities did not improve the prediction of 30-day mortality compared to a model without surgical risk (AUC 0.86 vs 0.86; P=0.831).
Why the study?
The study was designed to estimate the surgical risk of noncardiac procedures on the incidence of 30-day mortality in children with congenital heart disease.
Does integrating intrinsic surgical risk with patient comorbidities improve the prediction of 30-day mortality in children with congenital heart disease undergoing noncardiac surgery?
Population
37,658 derivation and 13,129 validation children with congenital heart disease undergoing noncardiac surgery
Comparison
High surgical risk vs low surgical risk procedures
Design
Registry-based retrospective cohort study with external validation
Follow-up
30 days
Authors
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Findings support simplified comorbidity-based mortality prediction without surgical risk integration; leaves open need for validation in prospective cohorts.
Cohort (n=50,787)
Yes
Does integrating intrinsic surgical risk with patient comorbidities improve the prediction of 30-day mortality in children with congenital heart disease undergoing noncardiac surgery?
Odds Ratio: 0.75 (95% CI 0.62–0.91)
Patient comorbidities and severity of the cardiac lesion, rather than intrinsic surgical risk, are the predominant predictors of 30-day mortality in children with congenital heart disease undergoing noncardiac surgery.
Faraoni et al. (2020) conducted a cohort in Congenital heart disease (n=50,787). Intrinsic surgical risk vs. Patient comorbidities alone was evaluated on 30-day mortality (adjusted OR 0.75, 95% CI 0.62-0.91). Integrating intrinsic surgical risk with patient comorbidities did not improve the prediction of 30-day mortality compared to a model without surgical risk (AUC 0.86 vs 0.86; P=0.831).
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