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Short- and Long-Term Survival Prediction Using Different Prognostic Scores in Cardiovascular Surgeries.

Alexandros C Liatsos1, Styliani Ioakeimidou2, Mairi Panagidi3

  • 1Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

Journal of Clinical Medicine
|April 14, 2026
PubMed
Summary

Early postoperative intensive care unit (ICU) severity scores, specifically the Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, effectively predict major complications and mortality after cardiac surgery. These ICU scores demonstrated superior prognostic value compared to traditional preoperative risk scores.

Keywords:
APACHE II scoreEuroSCORE IIKarnofsky scoreSOFA scorepostoperative mortalityrisk stratification

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Identifying patients at high risk for adverse outcomes post-cardiac surgery is a significant clinical challenge.
  • Preoperative risk scores are standard, but the prognostic utility of early postoperative Intensive Care Unit (ICU) severity scores and functional measures requires further investigation.

Purpose of the Study:

  • To evaluate the predictive performance of various preoperative and early postoperative scores for adverse outcomes after cardiac surgery.
  • To compare the prognostic value of the EuroSCORE II, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Karnofsky performance status, handgrip strength, and phase angle for predicting postoperative complications and mortality.

Main Methods:

  • A prospective observational study involving 195 patients undergoing cardiac surgery.
  • Assessment of predictive performance using Receiver Operating Characteristic (ROC) curves and 95% confidence intervals.
  • Analysis of major postoperative complications using a composite endpoint (stroke, prolonged intubation, sepsis, reoperation), excluding SIRS.

Main Results:

  • The SOFA score exhibited the highest predictive accuracy for major postoperative complications (AUC = 0.881) and in-hospital mortality (AUC = 0.915).
  • APACHE II also showed strong predictive performance for complications (AUC = 0.826) and mortality (AUC = 0.869).
  • Both SOFA and APACHE II scores outperformed the preoperative EuroSCORE II in predicting major complications and in-hospital mortality.

Conclusions:

  • Early postoperative ICU severity scores, particularly SOFA and APACHE II, are powerful predictors of major complications and in-hospital mortality following cardiac surgery.
  • These ICU-based scores offer superior prognostic value compared to traditional preoperative risk assessment tools for this patient population.