External validation of PreOpNet to predict 30-day mortality after major non-cardiac surgery using digital electrocardiogram

Figures

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  Fig. 1. Patient flowchart. ECG electrocardiogram, hs-cTnT high-sensitivity cardiac troponin T.

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  Fig. 2. Prognostic performance of the PreOpNet model. a Distribution of predicted risk for death predictions; b Receiver-operating-characteristic curve showing the discrimination of PreOpNet for predicting death within 30 days after surgery; c Calibration curve for PreOpNet, assessing the agreement between predicted and observed risk of death within 30 days after surgery. The red line represents optimal calibration, the black solid line the calibration curve, and the black dashed line the 95% confidence interval of the calibration curve; d Distribution of predicted risk for MACE predictions; e Receiver-operating-characteristic curve showing the discrimination of PreOpNet for predicting MACE within 30 days after surgery; f Calibration curve for PreOpNet, assessing the agreement between predicted and observed risk of MACE within 30 days after surgery. The red line represents optimal calibration, the black solid line the calibration curve, and the black dashed line the 95% confidence interval of the calibration curve. AUC Area under the receiver operating characteristic curve, CI Confidence interval.

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  Fig. 3. Forest plot of the discrimination of the PreOpNet model across patient subgroups. Discrimination for predicting a death and b MACE within 30 days. AUC Area under the receiver operating characteristic curve, CI confidence interval, ECG electrocardiogram, RCRI Revised cardiac risk index, eGFR Estimated glomerular filtration rate, Hs-cTnT High-sensitivity cardiac troponin T.

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  Fig. 4. Discrimination of PreOpNet, hs-cTnT and RCRI. Receiver-operating-characteristic curves showing the discrimination of the PreOpNet model (green), high-sensitivity cardiac troponin T (blue), and the RCRI (red) for predicting a death and b MACE within 30 days. RCRI Revised cardiac risk index, AUC Area under the receiver operating characteristic curve, CI Confidence interval, Hs-cTnT High-sensitivity cardiac troponin T.

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  Fig. 5. Prognostic performance of PreOpNet using a population-wise normalization as the final step of preprocessing. a Distribution of predicted risk for death predictions; b Receiver-operating-characteristic curve showing the discrimination of PreOpNet, hs-cTnT and RCRI for predicting death within 30 days after surgery; c Calibration curve of PreOpNet assessing the agreement between predicted and observed risk of death within 30 days after surgery. The red line represents optimal calibration, the black solid line the calibration curve, and the black dashed line the 95% confidence interval of the calibration curve; d Distribution of predicted risk for MACE predictions; e Receiver-operating-characteristic curve showing the discrimination of PreOpNet, hs-cTnT and RCRI for predicting MACE within 30 days after surgery; f Calibration curve of PreOpNet assessing the agreement between predicted and observed risk of MACE within 30 days after surgery. The red line represents optimal calibration, the black solid line the calibration curve, and the black dashed line the 95% confidence interval of the calibration curve. RCRI Revised cardiac risk index, AUC Area under the receiver operating…