Current cardiac surgery risk models focus mainly on mortality and lack intra/postoperative variables, highlighting the need for comprehensive models, particularly for unique populations like in sub-Saharan Africa.
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Existing models warrant cautious use beyond mortality or outside sub-Saharan Africa; leaves open development of morbidity-focused, regionally tailored tools.
Risk models are widely used to predict outcomes after cardiac surgery. Not only is risk modelling applied in the assessment of the relative impact of specific risk factors on surgical outcomes, but also in patient counselling, the selection of treatment options, comparison of postoperative results, and quality-improvement programmes. At least 19 risk-stratification models exist for open-heart surgery. The focus of risk models was originally on pre-operative prediction of mortality. However, major morbidity is in general more common than mortality and the ability to predict only operative mortality is not an adequate method of determining surgical outcome. Multiple intra- and postoperative variables have been excluded in the majority of models and the possible effect of their future inclusion remains to be seen. The unique patient population of sub-Saharan Africa requires a unique risk model that reflects the patient population and levels of care.
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Prins et al. (2012) studied this question.
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