Early Postoperative Complications and Risk Assessment in Cardiac Surgery: A Cohort Study

Early postoperative complications are major determinants of outcomes after cardiac surgery, particularly in low- and middle-income countries (LMICs), where perioperative data remain limited.

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.

Retrospective, single-center cohort study conducted at a national referral hospital.

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.

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.

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.

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.